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Prevalence of Health-Related Social Needs: Inpatient Versus Ambulatory Pediatric Populations
Hemen Muleta1, Samantha Levano2, Jonathan Gabbay1
1Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY.
Insights
Hospitalized children face a higher prevalence of unmet health-related social needs (HRSNs) compared to those in outpatient settings. Targeted inpatient interventions are crucial for supporting these vulnerable families and addressing their social determinants of health.
Area of Science:
- Pediatric Health
- Social Determinants of Health
- Health Services Research
Background:
- Health-related social needs (HRSNs) significantly impact pediatric health outcomes.
- Understanding the disparity in HRSNs prevalence between ambulatory and inpatient settings is crucial for effective intervention.
Purpose of the Study:
- To compare the prevalence of unmet HRSNs in pediatric patients across ambulatory and inpatient settings.
- To identify specific patient demographics with higher odds of unmet HRSNs within a tertiary children's hospital.
Main Methods:
- Retrospective study of pediatric patients (≤20 years) screened for HRSNs between November 2023 and November 2024.
- Comparison of inpatient and ambulatory samples using logistic regression models.
- Analysis of demographic factors associated with unmet HRSNs.
Main Results:
- Overall HRSN prevalence was 12.6% in ambulatory vs. 28.1% in inpatient settings.
- Hospitalized children had more than double the odds of reporting unmet HRSNs (aOR 2.41).
- Hispanic, Non-Hispanic Black, and other racial/ethnic groups, along with Spanish speakers, showed increased odds of unmet HRSNs.
Conclusions:
- Hospitalized pediatric patients exhibit a significantly higher prevalence of unmet HRSNs.
- Interventions focused on the inpatient setting are essential to address the needs of hospitalized children and their families.
- Addressing racial, ethnic, and linguistic disparities in HRSNs is critical for equitable care.
Objective:
To compare the prevalence of unmet health-related social needs (HRSNs) among pediatric patients in ambulatory and inpatient settings within a tertiary children's hospital in Bronx, New York.
Study Design:
This was a retrospective study of patients ≤20 years old who were screened for unmet HRSNs between November 1, 2023, and November 30, 2024. We compared inpatient and ambulatory pediatric samples using unadjusted and adjusted logistic regression models.
Results:
Overall, 29 233 patients were screened for HRSNs during the study period, with 25 909 (88.6%) patients screened in ambulatory settings and 3324 (11.4%) in inpatient units. The prevalence of unmet HRSNs was 12.6% in the ambulatory setting and 28.1% in the inpatient setting. Hospitalized patients had greater odds (aOR 2.41, 95% CI 2.20-2.63) of reporting at ≥1 unmet HRSNs compared with ambulatory patients. Hospitalized patients also demonstrated greater odds of reporting needs within each individual HRSNs domains. Within the inpatient sample, those 12-17 years of age had lower odds of unmet HRSNs than patients 0-5 years of age (aOR 0.75, 95% CI 0.61-0.92). Those who spoke Spanish (aOR 1.80, 95% CI 1.49-2.19) or identified their race and ethnicity as Hispanic (aOR 2.24, 95% CI 1.31-3.81), Non-Hispanic Black (aOR 2.48, 95% CI 1.45-4.25), or other (aOR 1.82, 95% CI 1.02-3.25) had greater odds of unmet HRSNs than English-speaking and Non-Hispanic White patients, respectively.
Conclusions:
Within the study, children who were hospitalized were more likely to have unmet HRSNs compared with patients who were ambulatory. Inpatient focused interventions are needed to support hospitalized families.
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