Abstract
Social Determinants of Health (SDoH) are socioeconomic indicators that directly or indirectly impact individual and community health outcomes. The distribution of most of these indicators within communities can be traced to public policies. These public policies often lead to diverse inequities with varying impacts on communities across the country. The inequities that arise because of specific public policies can be associated with increased risk factors and poor health outcomes among communities at high risk for these indicators. This study examined inpatient hospitalization and SDoH indicators that put individuals at risk of poor health outcomes. We utilized the National Inpatient Sample (NIS) databases 2012-2014 and 2016-2017 through the Healthcare Cost and Utilization Project (HCUP). The NIS datasets are de-identified to ensure patients' privacy. The HCUP-NIS dataset is a well-established sizable all-payer inpatient dataset for national estimates. It includes primary, secondary inpatient diagnoses as well as demographic information. SDoH indicators were identified using the International Classification of Diseases (ICD), versions 9 and 10 diagnosis codes. The relationship between SDoH indicators such as housing, psychosocial, healthcare access, upbringing, unemployment, social factors, gender, race, income, region, payer, age group, mortality, and severity was evaluated in a regression analysis. A total of 3,002,557 (2012-2014) and 1,254,899 (2016-2017) cases were included in this study. Mental diseases (p < 0.001) were high between 2012-2014 (OR 18.8, 95% CI 18.20-19.42) and 2016-2017 (OR 4.11, 95% CI 3.99-4.23). Native Americans had odds of presentation (p < 0.001) with SDoH indicator between 2012-2014 (OR 1.15, 95% CI 1.12-1.18) and 2016-2017 (OR 1.75, 95% CI 1.70-1.79). The odds of presentation among long income group were high compared to other income categories (p < 0.001) between 2012-2014 (OR 1.15, 95% CI 1.15-1.16) and 2016-2017 (OR 1.26, 95% CI 1.28-1.32). In conclusion, disparities, severity, and mortality risk at presentation were high among minority communities, males, and low-income demographics across all regions of United States
Highlights
Social Determinants of Health (SDoH) are essential indicators that directly or indirectly impact one's ability to effectively manage medical conditions and outcomes [1,2,3]
This study aims to provide an overview of how healthcare organizations and hospitals or direct care providers could inculcate SDoH indicators as part of their community health evaluation and assessment [11]
The relationship between SDoH indicator and alcohol and the drug-related presentation were significant (p < 0.001) between 2012-2014 and 2016-2017
Summary
Social Determinants of Health (SDoH) are essential indicators that directly or indirectly impact one's ability to effectively manage medical conditions and outcomes [1,2,3]. Given the variances in presentations, health outcomes among individuals meeting these SDoH classifications need careful evaluation to ensure practical and strategic approaches to addressing them [5,6]. These SDoH have been shown to disproportionally affect low-income and minority communities across the country [7,8,9]. Inpatient data is rarely utilized in understanding some of the factors that play a crucial role in patient presentations Utilization of such data in combination with the outpatient and community service providers’ data could provide a much better overview of the impact of such determinants on hospitalization and community resource allocation. This study evaluates the dynamics associated with socioeconomic and demographic factors impacting inpatient presentation of patients with SDoH indicators
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