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Observational Study
. 2023 Dec;26(6):413-419.
doi: 10.1089/pop.2023.0171. Epub 2023 Oct 31.

Examining the Association of Social Needs with Future Health Care Utilization in an Older Adult Population: Which Needs Are Most Important?

David M Mosen  1 , Matthew P Banegas  1   2 , Erin M Keast  1 , John F Dickerson  1
Affiliations
Observational Study

Examining the Association of Social Needs with Future Health Care Utilization in an Older Adult Population: Which Needs Are Most Important?

David M Mosen et al. Popul Health Manag. 2023 Dec.

Abstract

Abstract Social needs, such as social isolation and food insecurity, are important individual-level social determinants of health, especially for adults ages 65 years and older. These needs may be associated with future health care utilization, but this research area has not been studied extensively. The objective of this study was to examine the independent association of 5 individual social needs with future (1) emergency department (ED) visits and (2) hospital admissions. This observational study included 9649 Kaiser Permanente Northwest (KPNW) Medicare members who completed the Medicare Total Health Assessment (MTHA) quality improvement survey between August 17, 2020 and January 31, 2022. The 5 social needs assessed by the MTHA, defined as binary measures (yes/no), included (1) financial strain, (2) food insecurity, (3) housing instability, (4) social isolation, and (5) transportation needs. ED utilization (yes/no) and hospitalization (yes/no), the current study outcome measures, were measured in the 12 months after MTHA assessment. In multivariable analyses, 3 of the 5 social needs were significantly associated with higher ED utilization: financial strain (odds ratio [OR] = 1.40, 95% confidence interval [CI] = 1.11-1.76, P < 0.05), housing instability (OR = 1.43, 95% CI = 1.02-1.99, P < 0.05), and social isolation (OR = 1.19, 95% CI = 1.05-1.34, P < 0.05), and 1, financial strain, was significantly associated with hospital admissions (OR = 1.66, 95% CI = 1.23-2.23, P < 0.05). The study results identified which social needs are most strongly associated with future ED utilization and hospital admissions. Further research is needed to better understand whether addressing social needs is associated with improved patient-level health outcomes over time.

Keywords: Medicare; health care utilization; social needs.

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Conflict of interest statement

No competing financial interests exist.

Figures

FIG. 1.
FIG. 1.
Andersen behavioral model of health care utilization.
See this image and copyright information in PMC

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