Health-Related Social Needs and Health Care Utilization in the Accountable Health Communities Model.

Area of Science:

• Health Services Research
• Social Determinants of Health
• Public Health Policy

Background:

• Health-related social needs (HRSNs) significantly impact healthcare utilization.
• Understanding the association between HRSNs and healthcare use is crucial for health systems.
• The Accountable Health Communities (AHC) program screens for various HRSNs.

Purpose of the Study:

• To examine the association between HRSNs and inpatient (IP) and emergency department (ED) utilization.
• To determine if the resolution of HRSNs is associated with a reduction in healthcare utilization.

Main Methods:

• Retrospective cohort study of 166,682 Medicare and Medicaid recipients screened for HRSNs.
• Assessed housing stability, quality, food security, transportation, utilities, and interpersonal safety.
• Analyzed IP admissions and ED visits 6 months before and after screening/follow-up.

Main Results:

• Most HRSNs were associated with ED visits, with housing stability and transportation showing the strongest links.
• Housing stability and transportation were also associated with increased IP admissions.
• Resolution of HRSNs was not significantly associated with reduced healthcare utilization in follow-up analyses.

Conclusions:

• While most HRSNs are linked to increased ED use, resolving these needs did not demonstrably reduce utilization in this study.
• Further research is needed to understand the dynamic nature of HRSNs and their impact on healthcare use.
• Findings highlight the complexity of addressing social needs to reduce healthcare system burden.