Social Risks and Health Care Use in Medically Complex Patients

Area of Science:

• Health Services Research
• Social Determinants of Health
• Health Economics

Background:

• Integrated health care systems are increasingly investing in identifying and addressing social risks.
• Patients with multiple medical conditions (complex multimorbidity) are particularly vulnerable to the impact of social risks on their health outcomes.

Purpose of the Study:

• To evaluate the association between social risks and healthcare utilization among patients with moderate and high medical complexity.
• To inform interventions aimed at mitigating the impact of social risks on healthcare use.

Main Methods:

• Longitudinal cohort study of 97,252 Kaiser Permanente Northern California (KPNC) patients.
• Categorized patients into moderate and high medical complexity groups.
• Assessed social risks (e.g., financial assistance needs, social barriers to care) and tracked inpatient, outpatient, and emergency department (ED) visits over 12 months.

Main Results:

• Patients with social risks and moderate medical complexity had higher odds of inpatient admissions (OR, 1.2), ED visits (OR, 1.2), and mental health visits (OR, 1.2).
• Patients with social risks and high medical complexity showed increased odds of inpatient admissions (OR, 1.2), ED visits (OR, 1.2), 30-day readmissions (OR, 1.2), and mental health visits (OR, 1.3).

Conclusions:

• Social risks are significantly associated with increased healthcare utilization in patients with medical complexity.
• Concurrent efforts to identify and reduce social risks are essential for managing healthcare use among patients with complex medical conditions.