Adam Schickedanz|Adam L. Sharp|Yi R Hu|Nirav R. Shah|John Adams|Damon Francis|Artair Rogers
Impact of Social Needs Navigation on Utilization Among High Utilizers in a Large Integrated Health System: a Quasi-experimental Study
University of California, Los Angeles|Kaiser Permanente|Kaiser Permanente|Stanford University|Kaiser Permanente
programs addressing social determinants health highutilizing patients gaining interest among health systems avenue promote health decrease utilizationto evaluate impacts social needs screening navigation program adult predicted high utilizers total medical visit utilizationa prospective quasiexperimental study using intenttotreat propensityweighted differenceindifferences approach stratified analyses assessed intervention effects among three lowsocioeconomic status subsamples patients lowincome areas loweducation areas medicaid insurancepredicted high utilizerspatients predicted highest 1 total utilization large integrated health systema telephonic social needs screening navigation programprimary differenceindifference analyses compared total visit count utilization including outpatient emergency department ed inpatient utilization intervention control groups innetwork outofnetwork facilities prevalence social needs among sample patients connection rates social needs resources also describedthe study included 34225 patients 7107 intervention 27118 control 53 patients screened reported social needs minority 10 need able connect resources address needs primary analysis found total utilization visits decreased 22 95 ci 45 01 p 0058 intervention group stratified analyses showed decreases total utilization lowsocioeconomic status subgroups receiving intervention compared controls 70 95 ci 119 19 p 0008 lowincome area group 115 176 50 p 0001 loweducation area group 121 181 56 p 0001 medicaid groupsocial needs navigation programs highutilizing patients may modest effects utilization population overall however significant decreases utilization found among lowsocioeconomic status patients likely experience social needs