Social Determinants of Health Needs and Pediatric Health Care Use

Abstract

To examine the associations between family-reported social needs in primary care settings and pediatric health care use. Data were obtained for a sample of 56 253 children and youths (age 0-21years) who received primary care at a large hospital-based pediatric institution between June 2018 and October 2019 to estimate a propensity score for the probability of being seen in a primary care clinic. Inverse probability weighted regression specifications were used to examine the associations between reported social needs and health care use. Families were asked about 4 social needs: housing, utilities, transportation, and food. Outcomes included the number of Emergency Department (ED), inpatient, social work, and well-child visits (only for those aged 0-2years) in the 6months before and after needs screening. Overall, 12.0% of the families reported a general social need, with 28% of those needs identified as urgent. Food and transportation needs were most common. Patients with needs were more likely to have an ED or inpatient visit at 6months prescreening and 6months postscreening compared with those without needs. Among children aged <2years, those with a social need were less likely to have completed a well-child visit at 6months postscreening compared with those without a need. Social needs are linked to less preventive care use and greater reliance on emergency care services. Understanding how to better assist families in need requires greater attention.