Home Perspectives & Insights Evidence-based Linkages of SDoH to Health Outcomes – Part 3

Evidence-based Linkages of SDoH to Health Outcomes – Part 3

Perspectives & Insights · February 3, 2022 · Comments off

Association Between Social Determinants of Health and Acute Care Utilization Among Older Adults Enrolled in Medicare Advantage

By: Don Gerdts (don.gerdts@3aimstrategy.com), August 16, 2022

SUMMARY

A study titled, “Association Between Self-reported Health-Related Social Needs and Acute Care Utilization Among Older Adults Enrolled in Medicare Advantage” published in JAMA Health Forum found that certain social determinants of health were associated with statistically significantly higher rates of acute care utilization, which included >50% increases in avoidable hospital stays and emergency department visits.

In the population of over 56,000 Medicare Advantage beneficiaries, almost 50% reported one or more health-related social needs (HSRN).  The exposures evaluated included food insecurity, financial strain, loneliness, unreliable transportation, utility insecurity, housing insecurity, and poor housing quality. 

The results of the study show the following:

  1. Compared with beneficiaries without HRSNs, beneficiaries with an HRSN had a 53.3% higher rate of avoidable hospitalization.
  2. Financial strain (+26.5%) and unreliable transportation (+51.2%) were each independently associated with increased rates of hospital stays.
  3. Except for utility insecurity, all the listed exposures were independently associated with increased rates of ED visits.
  4. The social determinant with the largest association with increased hospital stays and ED visits was unreliable transportation.
  5. Financial strain (+0.4%) and unreliable transportation (+3.3%) were also marginally associated with increased 30-day readmission rates.

CONCLUSION

While these risk factors do not stand alone the study identifies the significant role of specific social exposures in determining the increased incidence of avoidable hospitalizations, ED visits and 30-day readmission rates.  These results negatively affect the Triple Aim of value-based care by increasing cost of care without improving quality or outcomes.

Understanding how different HRSNs relate to different health outcomes can inform targeted, evidence-based policies, investments, and innovations to address specific social determinants of health without “medicalizing” them.

TripleAim Strategy Advisors can help stakeholders in the healthcare ecosystem as a consultant or advisor to identify the most prevalent social determinants of health linked to health outcomes and develop strategies to address them in pursuit of improving equitable, value-based care.

Contact us to discuss this important topic or see additional ways we can help!

Don

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