Social Needs of Children With Medical Complexity and Inpatient Care Utilization

Area of Science:

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

Background:

• Children with medical complexity (CMC) often have unmet social needs that can impact their health outcomes.
• Social needs screening is increasingly used to identify these challenges in pediatric populations.
• Understanding the link between social needs and healthcare utilization is vital for resource allocation and patient support.

Purpose of the Study:

• To determine if CMC with positive social needs screens exhibit higher readmission rates and longer lengths of stay (LOS).
• To quantify the association between identified social needs and hospital utilization metrics in CMC.
• To provide evidence for targeted interventions supporting CMC with social needs.

Main Methods:

• A retrospective cohort study analyzed CMC aged 0-21 years admitted to a tertiary children's hospital.
• Patients with at least three subspecialists and medical technology use were included.
• Social needs were assessed via caregiver surveys, with positive screens indicating at least one reported need. Readmission rates and LOS were compared between groups.

Main Results:

• Four hundred eighty-four CMC were included: 129 with positive screens and 355 with negative screens.
• CMC with positive screens showed a significantly higher 30-day readmission rate (36% vs 26%) and longer LOS (6 days longer).
• Demographics differed, with higher representation of Black/African American and Hispanic/Latinx patients in the positive screen group.

Conclusions:

• Positive social needs screens in CMC are associated with significantly increased hospital utilization, including higher readmission rates and longer hospital stays.
• These findings underscore the critical impact of social needs on the healthcare burden of CMC.
• Interventions addressing social determinants of health are essential for optimizing care and reducing hospital resource use for this vulnerable population.