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Characteristics Associated With Positive Social Determinants of Health Screening in Patients Admitted to Pediatric
Gift Kopsombut1,2,3, Kathleen Rooney-Otero1,3, Emily Craver4
1Department of Pediatrics, Division of Hospital Medicine.
Insights
Screening hospitalized children for social determinants of health (SDOH) identified needs in 27% of families. Positive SDOH screening did not increase hospital length of stay, readmissions, or acute care use.
Area of Science:
- Pediatric Health
- Social Determinants of Health
- Health Services Research
Background:
- Limited research exists on screening for social determinants of health (SDOH) in hospitalized pediatric patients.
- Understanding patient characteristics associated with SDOH needs is crucial for targeted interventions.
- This study examines SDOH screening in a pediatric hospital setting and its relation to acute care metrics.
Purpose of the Study:
- To describe patient characteristics related to social determinants of health (SDOH) screening in hospitalized pediatric patients.
- To examine the association between positive SDOH screening results and acute care metrics.
- To identify populations at higher risk for unmet SDOH needs in pediatric hospital settings.
Main Methods:
- Retrospective cohort study of pediatric patients from July 2020 to October 2021.
- A 14-question social determinants of health (SDOH) screener was administered to families.
- Data collected included screen results, demographics, comorbidities, patient complexity, and acute care metrics; analyses used generalized estimation equation logistic regression.
Main Results:
- Social determinants of health (SDOH) screening was completed in 65% of patient encounters, with 27% identifying at least one need.
- Positive SDOH screening was associated with non-English primary language, Black or Hispanic ethnicity, and children on the complex care registry.
- Positive SDOH screening was not associated with increased length of stay, readmission, or 2-year emergency department/acute care utilization.
Conclusions:
- Hospitalized pediatric patients with non-English primary languages, certain racial/ethnic backgrounds, or complex care needs are at higher odds for positive social determinants of health (SDOH) screening.
- Positive social determinants of health (SDOH) screening in this cohort did not correlate with adverse acute care outcomes.
- Findings highlight the importance of targeted SDOH screening in vulnerable pediatric populations without evidence of increased resource utilization.
Background And Objective:
There is limited research on screening for social determinants of health (SDOH) in hospitalized pediatric patients. In this article, we describe patient characteristics related to SDOH screening in the hospital setting and examine relationships with acute care metrics.
Methods:
This is a retrospective cohort study. From July 2020 to October 2021, a 14-question SDOH screener was administered to families of patients admitted or transferred to the hospital medicine service. Information was collected regarding screen results, demographics, patient comorbidities, patient complexity, and acute care metrics. Unadjusted and multivariable analyses were performed using generalized estimation equation logistic regression models.
Results:
Families in 2454 (65%) patient encounters completed SDOH screening, with ≥1 need identified in 662 (27%) encounters. Families with significant odds for positive screening results in a multivariable analysis included primary language other than English (odds ratio [OR] 4.269, confidence interval [CI] 1.731-10.533) or Spanish (OR 1.419, CI 1.050-1.918), families identifying as "Black" (OR 1.675, CI 1.237-2.266) or Hispanic (OR 1.347, CI 1.057-1.717) or having a child on the complex care registry (OR 1.466, CI 1.120-1.918). A positive screening result was not associated with increased length of stay, readmission, or 2-year emergency department or acute care utilization.
Conclusions:
In hospitalized pediatric patients, populations at the greatest odds for positive needs include families with primary languages other than English or Spanish, those that identified as certain races or ethnicities, or those having a child on the complex care registry. A positive SDOH screening result in this study was not associated with an increase in length of stay, readmission, or acute care utilization.
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