973-P: Unmet Social Needs and Emergency Department Visits and Hospitalization among U.S. Safety-Net Health Center Patients with Both Diabetes and Hypertension

Abstract

Introduction: Diabetes and hypertension coexist in approximately 40 to 60% of patients with type 2 diabetes. This study examined the association between unmet social needs and emergency department (ER) visits and hospitalizations for this high group. Methods: Cross-sectional data on adults (aged≥18 years) with self-reported diabetes from the 2014 National Health Center Patient Survey (HCPS) was analyzed. The HCPS is a nationally representative survey of patients who receive care at safety-net health centers. Outcomes (binary) were the ER visits or hospitalizations due to diabetes and hypertension (HBP) in prior 12 months. The independent variables were 17 SDOH unmet social factors clustered three domains: (1) basic needs; (2) Health-related social needs (i.e., transportation, medical interpreter) and (3) adverse income or assets factors (food stamps and unstable housing). Responses were coded as binary (unmet or met). Logistic regression models with complex sampling design tested the association between adverse SDOH and the outcome, adjust for sociodemographic covariates. Results: The prevalence of HBP was 74.7% among diabetic adults. Among 910 participants (61.3% female and 25.6% Blacks) with comorbidities of diabetes and hypertension (16.9% weighted prevalence), 40.0 % were unstably housed and 52.1% were food stamp recipients and their top 3 unmet were home visit, find a job, and basic clothing/shoes. In the fully adjusted model, receiving food stamps and unmet needs in obtaining free medications were positively associated with, and unmet needs in free service outside health center were inversely associated with HBP related ER or hospitalization. Conclusions: Interventions that address unmet financial needs and help with obtaining free/affordable medications may improve health outcomes for this high-risk group. Disclosure A. Yan: None. M. N. Ozieh: None. Z. Shi: None.