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La asociación entre los riesgos sociales informados por los pacientes y el índice HOUSES: una comparación
Jessica L Sosso1, Karen M Fischer2, Chung-Il Wi2
1Mayo Clinic Health System, Sparta, WI, USA.
Journal of primary care & community health
|September 2, 2025
Resumen
Los factores de riesgo social son más comunes en las poblaciones rurales, pero esto se debe principalmente al estatus socioeconómico (SES) medido por el Índice HOUSES, no a la propia ruralidad. El Índice HOUSES identifica efectivamente a los pacientes en riesgo en los entornos de atención primaria.
Área de la Ciencia:
- Investigación de la atención primaria
- Determinantes sociales de la salud
- Disparidades en materia de salud
Sus antecedentes:
- Los factores de riesgo sociales tienen un impacto significativo en los resultados de salud de los pacientes.
- La evaluación del estatus socioeconómico (SES) es crucial para comprender las disparidades de salud.
- El índice HOUSES ofrece un nuevo método para la evaluación del SES utilizando datos de vivienda.
Objetivo del estudio:
- Determinar la prevalencia de los factores de riesgo social informados por los pacientes en un entorno de atención primaria rural.
- Evaluar la utilidad del índice HOUSES para evaluar el estatus socioeconómico (SES) en esta población.
- Examinar la relación entre el riesgo social, el índice HOUSES y la ruralidad.
Principales métodos:
- Análisis transversal de pacientes adultos de atención primaria en el Medio Oeste de los Estados Unidos.
- Indice HOUSES utilizado basado en la dirección del paciente para la clasificación del cuartil SES.
- Datos de riesgo social recogidos (vivienda, alimentación, transporte, finanzas, violencia) de los registros de salud.
- Utilizó modelos de efectos mixtos para analizar asociaciones.
Principales resultados:
- Los pacientes rurales informaron una mayor prevalencia de todos los factores de riesgo social y un menor SES (cuartiles HOUSES).
- El cuartil del índice HOUSES fue un predictor significativo de los factores de riesgo social (OR=2,27).
- La ruralidad no se asoció de forma independiente con el riesgo social después del ajuste por el índice HOUSES (OR=1,02).
Conclusiones:
- La mayor prevalencia de factores de riesgo social en las poblaciones rurales se explica en gran medida por el estatus socioeconómico (SES).
- El Índice HOUSES es una herramienta valiosa para identificar a los pacientes en riesgo en la atención primaria.
- El SES, más que la ruralidad per se, es un factor clave de riesgo social en esta población.
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