Pediatric Primary Care-Based Social Needs Services and Health Care Utilization

Area of Science:

• Health Services Research
• Social Determinants of Health
• Pediatric Healthcare

Background:

• Primary care settings increasingly screen for and address social needs.
• Understanding the impact of these services on healthcare utilization is crucial for practice sustainability and patient outcomes.

Purpose of the Study:

• To evaluate the relationship between the use of primary care-based social needs services and subsequent healthcare utilization.
• To examine patterns of ambulatory, emergency, and inpatient service use among patients accessing social needs support.

Main Methods:

• Retrospective cohort study (2012-2015) using electronic medical record data from an academic pediatric primary care practice.
• Logistic regression analyzed patient characteristics associated with social service use.
• Negative binomial models with inverse probability of treatment weights estimated the impact on service utilization.

Main Results:

• Forty-five percent of patients utilized social needs services, with higher use among those with complex medical conditions, lower income, and minority racial/ethnic groups.
• Patients using social services showed significantly higher rates of ambulatory (1.54), emergency (1.50), and inpatient (3.23) service utilization.
• No reduction in emergency or inpatient admissions was observed in conjunction with increased ambulatory service use.

Conclusions:

• Primary care social needs service use is linked to increased ambulatory care utilization.
• This pattern may reflect heightened healthcare needs or improved access to care.
• Financial implications for practices depend on healthcare payment models.