Bensken Wyatt P, Alberti Philip M, Stange Kurt C, Sajatovic Martha, Koroukian Siran M
Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, Ohio.
AAMC Center for Health Justice, Association of American Medical Colleges, Washington, District of Columbia.
Am J Prev Med. 2022 Apr;62(4):e232-e241. doi: 10.1016/j.amepre.2021.10.004. Epub 2021 Dec 2.
Health-related social needs are known drivers of health and health outcomes, yet work to date to examine health-related social needs using ICD-10 Z-codes remains limited. This study seeks to evaluate the differences in the prevalence of conditions as well as utilization and cost between patients with and without health-related social needs.
Using the 2017 Florida State Emergency Department and State Inpatient Databases, this study identified patients with documented health-related social needs using ICD-10 Z-codes. The prevalence ratio was calculated for 14 conditions that are the leading causes of mortality and economic costs. In addition, ratios for the median total number of negative health events and total annual costs between patients with health-related social needs and those without health-related social needs across these conditions were calculated. Data analysis was conducted in 2021.
Of 4,477,772 patients, 46,081 (1.0%) had documented health-related social needs and had 4 times the negative health events and 9.3 times the total annual costs. Trends of increased negative health events and costs were seen across all examined conditions; patients with health-related social needs had 2.5-3.5 times the negative health events and 2-18 times greater total costs. The biggest difference in negative health events was seen in patients with unintentional injuries and depression and psychoses (3.5 times for patients with health-related social needs), whereas the biggest difference in total costs was for unintentional injuries (18.4 times for patients with health-related social needs).
This study shows the increased prevalence of numerous high-priority conditions as well as increased utilization and costs among patients with documented health-related social needs.
与健康相关的社会需求是已知的健康及健康结果的驱动因素，但迄今为止，使用国际疾病分类第十版（ICD - 10）Z编码来检查与健康相关的社会需求的工作仍然有限。本研究旨在评估有和没有与健康相关社会需求的患者在疾病患病率、医疗服务利用情况和费用方面的差异。
本研究使用2017年佛罗里达州急诊部门和住院患者数据库，通过ICD - 10 Z编码识别有记录的与健康相关社会需求的患者。计算了14种作为死亡和经济成本主要原因的疾病的患病率比。此外，还计算了在这些疾病中，有与健康相关社会需求的患者和没有与健康相关社会需求的患者之间负面健康事件总数中位数和年度总费用的比率。数据分析于2021年进行。
在4477772名患者中，46081名（1.0%）有记录的与健康相关社会需求，其负面健康事件是其他患者的4倍，年度总费用是9.3倍。在所有检查的疾病中均观察到负面健康事件和费用增加的趋势；有与健康相关社会需求的患者负面健康事件是其他患者的2.5至3.5倍，总费用是2至18倍。负面健康事件差异最大的是意外伤害以及抑郁和精神疾病患者（有与健康相关社会需求的患者是其他患者的3.5倍），而总费用差异最大的是意外伤害患者（有与健康相关社会需求的患者是其他患者的18.4倍）。
本研究表明，在有记录的与健康相关社会需求的患者中，多种高优先级疾病的患病率增加，医疗服务利用和费用也增加。
