Impact of Health Care and Socioeconomic Needs on Health Care Utilization and Disease Management: The University of New Mexico Hospital Care One Program

Abstract

Understanding how unmet basic needs impact health care in patients with complex conditions is vital to improve health outcomes and reduce health care costs. The purpose of this observational study was to explore the association between health care and socioeconomic needs and health care utilization and disease management among patients with chronic conditions at an intensive, patient-centered, office-based program. The study used a cross-sectional design and a convenience sampling approach. Data were collected through a patient questionnaire and medical records. Analysis included descriptive and inferential statistics. Data from 48 established patients were analyzed. Financial and lack of transportation were the 2 most frequently reported unmet needs. More than 65% of participants had their chronic condition(s) under control. Sex and ethnicity were the only 2 demographic variables that yielded significant differences (P ≤ 0.01) on visits to the emergency room and having chronic condition(s) under control. Those who reported having unmet transportation needs were more likely to have a condition uncontrolled and to have lost medical appointments compared to those who had this social need met (P ≤ 0.05). Statistically significant differences in terms of missing medical appointments also were found between those whose overall financial and housing needs were unmet and those who had those needs met (P ≤ 0.05). Results indicate that participating patients generally had good control of their conditions. The study adds evidence in support of the call for health care to address patients' socioeconomic needs, and the health care benefits of intensive case management programs. The model may be considered for adoption throughout New Mexico, and nationally.

Learning in real world practice: Identifying implementation strategies to integrate health-related social needs screening within a large health system

“…Evidence has shown that unmet HRSNs contribute to poor health outcomes through increased exposure to risk factors for chronic conditions, higher likelihood of chronic stress, and decreased access to resources for those with preexisting conditions [3]. Patients with HRSNs also have higher emergency department utilization [4][5][6], higher hospital admissions [7,8], higher rates of hospital readmission [9], and higher rates of missed ambulatory appointments [10,11], which coincide with higher cost to the health system [12]. Recent interventions integrating social care in clinical settings have demonstrated improvements in health outcomes and cost by addressing food security [13], housing stability [14,15], and legal assistance [16,17].…”