Abstract
New policies require hospitals to identify and address patients' health-related social needs (HRSN) yet provide minimal guidance on how screening should be conducted. This observational study occurred at a large academic hospital serving a diverse population. Hospital and research staff independently screened newly admitted medical patients for six HRSNs using an instrument designed by a quality improvement team. We calculated κ statistics to assess HRSN agreement between hospital and research staff. Analysis of 413 patients revealed fair to moderate agreement between hospital and research staff screenings (κ = 0.25-0.54). Hospital staff identified fewer patients with needs related to medication affordability, housing, food, transportation, and mental health, but identified a higher proportion with needs related to the usual source of care. Hospital staff underestimate the proportion of patients with HRSN, potentially excluding patients from referral to social services.