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Social Risk Factor Documentation in Emergency Departments
Melanie F Molina1, Matthew S Pantell2, Laura M Gottlieb3
1Department of Emergency Medicine, University of California-San Francisco, San Francisco, CA.
Annals of Emergency Medicine
|October 9, 2022
Summary
Social Z code documentation in emergency departments (EDs) is very low, affecting only 1.21% of visits. Increased documentation of these social risk factors could improve interventions and policy.
Area of Science:
- Health Informatics
- Public Health
- Social Determinants of Health
Background:
- Social Z codes are crucial for documenting social risk factors in electronic health records.
- Despite their availability, the prevalence of social Z code documentation in emergency departments (EDs) remains unexamined.
Purpose of the Study:
- To estimate the prevalence of social Z code documentation in US emergency department visits.
- To identify patient and hospital characteristics associated with social Z code documentation.
Main Methods:
- A descriptive, cross-sectional study utilizing the 2018 Nationwide Emergency Department Sample.
- Analysis included over 35.8 million adult and pediatric ED visits.
- Logistic regression was used to examine associations between documentation and various factors.
Main Results:
- A weighted prevalence of 1.21% (n=452,499) of ED visits had at least one documented social Z code.
- Documentation was significantly higher for patients aged 35-64, males, those with Medicaid, and those with a Charlson Comorbidity Index ≥1.
- ED visits for mental, behavioral, and neurodevelopmental illnesses showed the strongest association with social Z code documentation (OR 10.75).
Conclusions:
- The prevalence of social Z code documentation in US EDs is notably low.
- Systematic documentation can enhance targeted social interventions, inform social risk payment adjustments, and guide policy reforms.
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