Health-Related Social Needs Are Associated With Worse Physical Function, Pain, and Mobility in Hip and Knee...

Health-related social needs (HRSNs) are mandatory reporting measures per the Centers for Medicare & Medicaid Services. We sought to assess the prevalence of HRSNs and associations with clinical presentation among preoperative hip and knee osteoarthritis patients.

This prospective single-institution cross-sectional study assessed HRSNs (living situation, food, transportation, utilities, safety, financial strain, substance use, and mental health); Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function, Mobility, Pain Interference scores; and demographics (sex, race, education, income, household size, marital status) via in-person interviews in an academic arthroplasty practice. Kellgren-Lawrence Osteoarthritis Score, Charlson Comorbidity Index, and insurance were also determined. Odds of HRSNs by demographics were analyzed using logistic regression and relationship between HRSNs and PROMIS scores was determined by weighted least square linear regression.

The study included 253 patients. Prevalences of each HRSN were 15% for living situation, 13% for food insecurity, 11% for transportation, 4% for utilities, 0.4% for safety, 58% for mental health, 31% for substance use, and 27% for financial strain. Black patients and patients on Medicaid had higher HRSN prevalences. PROMIS scores were significantly worse in patients with HRSNs, particularly for living situation, financial strain, and mental health domains (P < .05 for Physical Function, Mobility, and Pain Interference scores in all these domains).

HRSNs are significant among hip and knee osteoarthritis patients and disproportionately high for Black and Medicaid patients. Patients with HRSNs presented with significantly worse PROMIS scores across Physical Function, Mobility, and Pain Interference domains, highlighting a healthcare disparity in this population.