1059-P: Unmet Social Needs and Diabetes-Related Emergency Department Visits and Hospitalization: A Nationally Representative Study of U.S. Safety-Net Health Center Patients

Abstract

Introduction: Evidence shows that social determinants of health (SDOH) account for more variation in health outcomes than medical care. This study examined the association between unmet social needs and diabetes-related emergency department (ER) visits and hospitalizations. Methods: Cross-sectional data on adults (aged≥18 years) with self-reported diabetes from the 2014 Health Center Patient Survey (HCPS) was analyzed. Outcome (binary) was diabetes-related ER visits or hospitalizations in prior 12 months. The independent variables were 17 SDOH unmet social factors clustered into three domains: (1) basic needs; (2) health-related social needs; and (3) adverse income or assets factors. Responses were coded as binary (unmet or met). Logistic regression models tested the association between adverse SDOH and outcome, adjusting for sociodemographic covariates. Results: Among 5592 participants (63.0% female and 22.8% Blacks), 1282 had diabetes (weighted prevalence=22.5%). Of the diabetic participants, 50.9% were unstably housed and 51.3% were food stamp recipients and their top 3 unmet needs were related to service from the health center (home visit, counseling, and health education). In the univariable model, no interpreting service and not receiving help from the health center were statistically inversely associated with, and unstable housing and receiving food stamps were positively associated with the outcome. In the fully adjusted model, those who received food stamps were 3.57 times more likely to have diabetes-related ER visits or hospitalization (95%CI: 1.08 - 11.82). Age was (45-54 vs. 18-44 yrs) (OR= 0.31 95%CI: 0.13-0.78) also significantly associated with ER visits or hospitalizations. Conclusions: Findings suggest that receiving food stamps was the strongest predictor for diabetes ER visit. Diabetes interventions that target food stamp/SNAP recipients may improve their health outcomes. Disclosure A. Yan: None. Z. Shi: None. M. N. Ozieh: None. J. S. Williams: None.