The Health and Social Needs of Patients Discharged From the Emergency Department With Suspected COVID-19

Public Health Rep. 2021 May;136(3):309-314. doi: 10.1177/0033354920982579. Epub 2021 Feb 16.

Abstract

Health-related social needs (HRSNs), such as food or housing insecurity, are important drivers of disparities in outcomes during public health emergencies. We describe the development of a telehealth follow-up program in Boston, Massachusetts, for patients discharged from the emergency department after coronavirus disease 2019 (COVID-19) testing to identify patients with worsening clinical symptoms, to screen for unmet HRSNs, and to deliver self-isolation counseling and risk-reduction strategies for socially vulnerable people. We prioritized telephone calls to patients with public health insurance and patients without primary care physicians. In the first 43 days of operation, March 30-May 12, 2020, our intervention reached 509 patients, with 209 (41.1%) patients reporting an HRSN, most commonly related to food, housing, or utilities. Thirty-one (6.1%) patients required assessment by a clinician for clinical worsening. This public health intervention may be useful for other institutions developing programs to address the social and health needs of patients discharged with suspected COVID-19.

Keywords: COVID-19; coronavirus; emergency department; health equity; health-related social needs.

MeSH terms

  • Boston / epidemiology
  • COVID-19 / diagnosis*
  • COVID-19 Testing*
  • Emergency Service, Hospital
  • Food Insecurity
  • Health Services Needs and Demand*
  • Housing
  • Humans
  • Patient Discharge*
  • Patient Isolation
  • SARS-CoV-2
  • Social Determinants of Health
  • Telemedicine*
  • Vulnerable Populations*