Feasibility of Screening for Financial Hardship and Health-Related Social Needs at Radiology Encounters

Riya Bansal; Desiree Anderson; Andrew Cuyegkeng; Thuan Gia-Nhat Tran; Arham Aijaz; Jasmine Dhillon; Ruth C Carlos; Gelareh Sadigh

doi:10.1016/j.jacr.2023.12.025

Feasibility of Screening for Financial Hardship and Health-Related Social Needs at Radiology Encounters

J Am Coll Radiol. 2023 Dec 28:S1546-1440(23)01044-X. doi: 10.1016/j.jacr.2023.12.025. Online ahead of print.

Authors

Riya Bansal¹, Desiree Anderson¹, Andrew Cuyegkeng¹, Thuan Gia-Nhat Tran¹, Arham Aijaz¹, Jasmine Dhillon¹, Ruth C Carlos², Gelareh Sadigh³

Affiliations

¹ Department of Radiological Sciences, University of California Irvine, Orange, California.
² Department of Radiology, University of Michigan, Ann Arbor, Michigan; and Editor-in-Chief, JACR.
³ Department of Radiological Sciences, University of California Irvine, Orange, California; Director of Health Services and Comparative Outcome Research at University of California Irvine, Orange, California; and Associate Editor, JACR. Electronic address: gsadigh@uci.edu.

PMID: 38159833
DOI: 10.1016/j.jacr.2023.12.025

Abstract

Objective: To evaluate the prevalence of financial hardship and health-related social needs (HRSNs) among outpatients undergoing advanced imaging services and assess the feasibility of screening for financial and social needs during radiology encounters.

Methods: Adult patients receiving CT, MRI, or PET/CT at outpatient imaging centers of an academic tertiary center were asked to complete a 15-minute survey with adapted validated questions inquiring about their experience of financial hardship related to imaging and HRSNs, and the appropriateness of screening for financial and social needs at radiology encounters. Logistic regression analyses were performed to assess factors associated with perceived appropriateness of screening and level of interest in meeting with financial counselors.

Results: A total of 430 patients responded (10.0% response rate; mean age: 57.1 years; 57.4% female; 54.5% White; 22.1% Hispanic; 19.1% Asian; 1% Black). A total of 35% reported experiencing financial hardship with imaging; 47.5% reported material hardship, 15.3% reported cost-related care nonadherence, and 5.3% reported cost-related imaging nonadherence. Overall, 35.9% had at least one HRSN, with food insecurity being the most common (28.3%). The majority (79.7%) felt that being screened for HRSNs at radiology encounters is appropriate, with those experiencing imaging hardship being more likely to feel that screening is appropriate (odds ratio [OR]: 2.93; 95% confidence interval [CI], 1.31-6.56). Overall, 29.5% were interested in meeting with a financial counselor, with those with imaging hardship (OR: 3.70; 95% CI, 1.96-6.97) and HRSNs (OR: 2.87; 95% CI, 1.32-6.24) and who felt uncomfortable with screening (OR: 2.83; 95% CI, 1.14-7.03) being more likely to be interested.

Discussion: Financial hardship and HRSNs are common among outpatients undergoing advanced imaging, with the majority reporting that getting screened at radiology encounters is appropriate.

Keywords: financial hardship; health-related social needs; radiology; screening.