Department of Urology, Montefiore Medical Center, Bronx, New York.
Albert Einstein College of Medicine, Bronx, New York.
Urol Pract. 2024 Jul;11(4):632-638. doi: 10.1097/UPJ.0000000000000571. Epub 2024 Jul 20.
Social determinants of health (SDH) are nonbiologic influencers of disease and health care disparities. This study focused on understanding the association between SDH and urology clinic "no-show" visits within a diverse urban population.
We retrospectively identified patients scheduled for urology clinic visits from October 2015 to June 2022 who completed a 10-question social needs screener. For each patient, demographic variables, and number of missed clinic appointments were abstracted. Multivariable logistic regression was performed to determine the association of unmet social needs and no-shows.
Of 5761 unique patients seen in clinic, 5293 completed a social needs screener. Respondents were most commonly male (62.8%), Hispanic (50.3%), English-speaking (75.5%), and insured by Medicare (46.0%). Overall, 8.2%, 4.6%, and 6.1% reported 1, 2, and 3+ unmet social needs, respectively. Most patients (61.7%) had 0 no-shows; 38.3% had 1+ no-shows. Between the 0 and 1+ no-show groups, we found significant differences with respect to gender ( =.05), race/ethnicity ( = .002), preferred language ( = .006), insurance payer ( < .001), SDH status ( = .003), and total number of unmet social needs ( = .006). On multivariable analysis, patients concerned about housing quality (odds ratio [OR] = 1.50, = .002), legal help (OR = 1.53, = .009), and with 3+ unmet social needs (OR = 1.39, = .006) were more likely to have 1+ no-shows.
Unmet social needs were associated with increased no-show urology clinic visits. Routine social needs screening could identify at-risk patients who would benefit from services. This may be particularly pertinent for patients with urgent diagnoses or those requiring frequent office visits where missing appointments could impact morbidity and mortality.
社会决定因素健康（SDH）是非生物因素对疾病和医疗保健差异的影响。本研究旨在了解在多样化的城市人群中，SDH 与泌尿科诊所“爽约”就诊之间的关联。
我们回顾性地确定了 2015 年 10 月至 2022 年 6 月期间在泌尿科诊所就诊并完成了 10 个问题社会需求筛查的患者。为每位患者提取人口统计学变量和错过的就诊次数。进行多变量逻辑回归以确定未满足的社会需求与爽约之间的关联。
在 5761 名接受过诊所治疗的患者中，有 5293 名患者完成了社会需求筛查。受访者最常见的是男性（62.8%）、西班牙裔（50.3%）、英语使用者（75.5%）和医疗保险（46.0%）。总体而言，分别有 8.2%、4.6%和 6.1%的患者报告有 1、2 和 3 个以上未满足的社会需求。大多数患者（61.7%）没有爽约；38.3%有 1 次爽约。在 0 次和 1 次爽约组之间，我们发现性别（ =.05）、种族/民族（ =.002）、首选语言（ =.006）、保险支付人（ <.001）、SDH 状况（ =.003）和未满足的社会需求总数（ =.006）存在显著差异。在多变量分析中，对住房质量（优势比[OR] = 1.50， =.002）、法律帮助（OR = 1.53， =.009）和 3 个以上未满足的社会需求（OR = 1.39， =.006）表示担忧的患者更有可能出现 1 次爽约。
未满足的社会需求与泌尿科诊所爽约就诊次数增加有关。常规的社会需求筛查可以识别出有风险的患者，他们将受益于服务。对于有紧急诊断或需要频繁就诊的患者来说，这可能尤其重要，因为错过预约可能会影响发病率和死亡率。
