Chang Ji E, Smith Nate, Lindenfeld Zoe, Weeks William B
Department of Public Health Policy and Management, New York University School of Global Public Health, New York, NY 10003, United States.
CareJourney, Arlington, VA 22203, United States.
Health Aff Sch. 2023 Dec 14;2(1):qxad086. doi: 10.1093/haschl/qxad086. eCollection 2024 Jan.
Recognizing the impact of the social determinants of health (SDOH) on health outcomes, in 2016, the Centers for Medicare and Medicaid Services recommended the use of (ICD-10), Z-codes to capture patients' health-related social needs. We examined changes in Z-code utilization to document health-related social needs for Medicare fee-for-service recipients among US hospitals between 2017 and 2021 across 5 common SDOH domains. We found that, while 56.9% of hospitals had at least 1 Z-code recorded in at least 1 patient per year, apart from those referring to housing needs, rates of Z-code adoption were low. Additionally, hospitals that were general medical, part of a teaching institution, affiliated with larger health systems, and of medium to large size had greater odds of utilizing Z-codes. Findings from this study highlight the need for continued efforts in promoting the consistent use of standardized SDOH capturing methods like Z-code documentation, such as provider training.
认识到健康的社会决定因素（SDOH）对健康结果的影响后，2016年，医疗保险和医疗补助服务中心建议使用国际疾病分类第十版（ICD - 10）中的Z编码来记录患者与健康相关的社会需求。我们研究了Z编码使用情况的变化，以记录2017年至2021年期间美国医院中医疗保险按服务收费受助者在5个常见的SDOH领域中与健康相关的社会需求。我们发现，虽然56.9%的医院每年至少有1名患者记录了至少1个Z编码，但除了那些涉及住房需求的编码外，Z编码的采用率较低。此外，综合医院、教学机构的一部分、隶属于大型医疗系统以及中大型规模的医院使用Z编码的几率更大。这项研究的结果凸显了持续努力推广像Z编码记录这样的标准化SDOH获取方法的一致使用的必要性，比如对医疗服务提供者进行培训。
