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

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.