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Social determinants of health (SDH) V codes are rarely used in hospitals, except for mental health and substance use cases. Incentives are needed to improve the capture of SDH data for better health insights.

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Area of Science:

  • Health Services Research
  • Public Health Informatics
  • Health Economics

Background:

  • Social determinants of health (SDH) data are crucial for clinical decisions and population health strategies.
  • The International Statistical Classification of Diseases and Related Health Problems (ICD) is a potential source for cataloging SDH data.
  • Understanding SDH data capture is vital for leveraging its applications in healthcare.

Purpose of the Study:

  • To investigate the utilization of ICD-Ninth Revision SDH V codes in a national inpatient discharge database.
  • To explore patterns of SDH V code assignment across different patient demographics and hospitalizations.

Main Methods:

  • Analysis of the 2013 Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample.
  • Estimation of ICD-9 SDH V code utilization rates overall and by patient characteristics (age, race, sex, payer).
  • Examination of SDH V code use for common reasons for hospitalization and conditions with high SDH V code rates.

Main Results:

  • Fewer than 2% of all inpatient discharges were assigned an SDH V code.
  • Significant variations in SDH V code utilization were observed across demographic and payer groups (P<0.001).
  • SDH V code use was concentrated in mental health and alcohol/substance use-related discharges.

Conclusions:

  • ICD-9 SDH V codes are underutilized in inpatient settings, primarily for non-mental health/substance use related cases.
  • Current utilization does not fully capture the breadth of SDH impacting patient health.
  • Development of utilization incentives is necessary to harness the full potential of SDH data collection.