(582) Association between Social Determinants of Health and Acute Care Utilization in Pregnancy

_{In non-pregnant populations, social needs, including housing instability, food insecurity, and neighborhood disadvantage, are associated with increased acute care utilization.  Our objective is to determine if patients reporting social needs have an increased number of triage visits during pregnancy and the immediate postpartum period compared to those not reporting social needs.} 

Study Design:
_{We conducted a prospective cohort study from October 2019 to July 2021 of 1608 pregnant patients who attended prenatal care at our institution.  Social needs within the prior 12 months were evaluated using the CMS/CMMI Accountable Health Communities- Health Related Social Needs Screening Tool.  Five core domains were evaluated including housing, utilities, transportation, food and interpersonal violence. We examined the association between each domain of social need (present/absent) and the number of triage visits.  We used Poisson regression to calculate unadjusted and adjusted risk ratios (aRRs), adjusting for race/ethnicity, parity, prenatal care utilization, and obstetric comorbidity score.} 

Results:
Of the 1608 patients who completed the social needs screening 81.2% were non-Hispanic Black and 87.4% had public insurance.  44.8% (720) of all patients screened reported having any social needs.  The most common reported needs were food (19.2%), housing (16.5%), and transportation (14.2%).  Patients who reported housing, utilities, or interpersonal violence social needs each had a higher mean number of triage visits than those without those social needs.  (Table 1).  After adjusting for confounders, the patients who reported housing (aRR 1.20), utilities (aRR 1.25), or interpersonal violence (aRR 1.37) social needs had an increased likelihood of high triage utilization. (Table 2)  

Conclusion:

Patients with housing, utility, and interpersonal violence needs had higher mean number of triage visits.  After controlling for confounders, these patients also had significantly higher risk of increased triage utilization.