Healthcare Utilization Following Implementation of a Pediatric Social Needs Screening Program

TL;DR

A social needs screening program in pediatric care reduced emergency and sick visits without affecting preventive care.

Contribution

This study demonstrates the impact of universal social needs screening on healthcare utilization patterns in pediatrics.

Findings

Post-implementation patients had fewer emergency visits (15.5% vs 13.1%) and sick visits (29.3% vs 24.3%).

Well-child visits remained stable between pre- and post-implementation groups.

Hospitalization rates slightly decreased but were not statistically significant (2.5% vs 2.0%).

Abstract

This study evaluated differences in healthcare utilization among a pediatric primary care population following implementation of a universal social needs screening and referral program. It was hypothesized that emergency, sick, and hospitalization visits would decrease post-implementation, with stable or increased preventive care.

A retrospective, observational study was conducted using electronic health record data from 2 cohorts at different time periods at a large academic pediatric primary care clinic. The pre-implementation group included patients with a well-child visit from 08/2021 to 07/2022; the post-implementation group included patients from 09/2022 to 08/2023. Healthcare utilization measures of emergency department visits, hospitalizations, sick visits, and subsequent well-child visits were assessed from the index visit through the end of the group period. Differences in healthcare utilization were compared between cohorts using Mann-Whitney U (MW) tests, and associations of visit counts with social needs and care coordination referrals were examined using backwards-selected Zero-inflated Poisson regression models.

The study included 3889 pre-implementation and 3813 post-implementation patients. Post-implementation patients had fewer emergency visits (≥1 visit: 15.5% vs 13.1%; MW P = .002) and sick visits (≥2 visits: 29.3% vs 24.3%; MW P < .001). Well-child visits did not differ (MW P = .981). Hospitalization rates were 2.5% pre-implementation and 2.0% post-implementation (MW P = .120).

Implementation of a universal social needs screening program was associated with improved patterns of pediatric healthcare utilization.

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