Prevalence of social risks among cancer patients in an integrated health system.

Abstract

195 Background: Social risks can lead to adverse cancer outcomes, including poor quality of life and increased mortality. These risks also contribute to health disparities and inequities, deepening needs for social care and support of cancer patients. Kaiser Permanente (KP) evaluated its social determinants of health (SDOH) questionnaires to assess the prevalence of social risks among cancer patients and members to design solutions that would address their social support needs. Methods: KP uses standard and non-standard SDOH questionnaires across markets to screen pediatric and adult members for social risk factors such as financial strain, housing instability, and social isolation. Screening is built into KP’s electronic health record (EHR), where the survey is administered by clinical staff, call center agents, or patients when logged into KP.org. SDOH screening data was collected between January 2021 to September 2022 for this analysis. Electronic Medical Record (EHR) and claims data were used to identify KP members with care associated with a cancer diagnosis between September 2017 to September 2022. Benign neoplasm and basal/squamous cell diagnoses were excluded. Results: There were 608K patients identified with visits associated with a cancer diagnosis in the 5-year period. Of these 608K cancer patients, 18% (n=109,773) were screened for social risk using standard and non-standard SDOH surveys. For comparable results across KP markets, standard questionnaires yielded 39% (n=7,507) presenting at least one positive social risk factor out of 19,274 cancer patients screened. Financial strain and social isolation were the most prevalent factors. Members across all major health plan products screened positive for at least one risk. When stratified by product, 65% (n=825) of Medicaid members screened were the highest observed group with at least 1 social risk, and commercial members screened were the second highest (40%, n=2,700). Cancer patients’ positive social risks were consistent with the overall screened population at 38% (n=102,392). Conclusions: KP cancer members yielded a similar measure of social risks as the general screened population, and the prevalence of these risks across major health plan products signals a call to action. The top social needs surfaced from this analysis informed how KP can support members by designing solutions that will provide access and referrals to appropriate resources. Deploying standardized social needs screenings and integrating them with clinical workflows are critical success factors. KP is building screening tools in multiple languages and will offer additional screening modalities to broaden equitable access. Though wide evidence demonstrates social factors have a major impact on health and well-being, more research is required to understand their effects on disparities, other dimensions of inequity, and health outcomes among cancer patients and members.