SHM Converge Scientific Abstract ePoster Gallery-Social Determinants of Health Experienced by Inpatients and Outpatients

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This study compared social determinants of health (SDoH) among hospitalized and outpatient clinic patients at UConn John Dempsey Hospital from September 2021 to May 2022. Using a volunteer-administered screening tool, the team assessed needs such as food insecurity, housing instability, transportation barriers, utility difficulties, phone access, insurance, medication affordability, employment, and language.<br /><br />A total of 2,041 adults were screened: 1,805 clinic patients and 236 hospitalized patients. Hospitalized patients were older and more likely to be male. Overall, hospitalized patients had significantly higher rates of several unmet needs than clinic patients, including unemployment, homelessness, housing insecurity, food insecurity, utility strain, lack of phone access, and transportation problems. For example, transportation needs were reported by 15% of hospitalized patients versus 9% of clinic patients, and housing insecurity by 13% versus 5%.<br /><br />In multivariable analysis, race, ethnicity, and hospitalization status were associated with unmet SDoH needs. Compared with other races, Black patients had higher odds of unmet needs, while White patients had lower odds. Hispanic patients had the highest risk, with nearly four times the odds of an unmet SDoH need. Hospitalization itself doubled the odds of having an unmet need.<br /><br />Among racial/ethnic subgroups, the pattern of needs differed: White hospitalized patients had more unmet needs than White clinic patients, while Black and Hispanic patients had elevated unmet needs in both settings, with particularly high housing and food insecurity among hospitalized Hispanic patients and high housing/utility strain among hospitalized Black patients.<br /><br />Importantly, hospitalized and clinic patients were similarly likely to accept community resources when needs were identified.<br /><br />The study concludes that hospitalized patients face a greater burden of unmet SDoH needs, and screening in both inpatient and outpatient settings can help identify and connect patients to support. Future research should examine whether addressing these needs improves outcomes such as readmissions.

Asset Subtitle

Christopher L. Steele

Meta Tag

Author List Christopher L. Steele, Erin Cova, Nivedha Natchiappan

Category Research

Concept Social Determinants of Health

Concept Hospitalized Patients

Concept Outpatient Clinic Patients

Concept Unmet Needs

Concept Housing Insecurity

Distinguished Non-Finalist

Presenter Organization UConn Health

Presenting Author Christopher L. Steele

Track Value in Hospital Medicine

Keywords

social determinants of health

hospitalized patients

outpatient clinic

food insecurity

housing instability

transportation barriers

racial disparities

Hispanic patients

Black patients

community resources

Social Determinants of Health

Hospitalized Patients

Outpatient Clinic Patients

Unmet Needs

Housing Insecurity