P4A166: Social Determinants of Health Screening in the Pediatric Hospital Medicine Setting: Comparison of Patient Specific Social Needs to Social Risk Indices

Background: There is currently limited research on social determinants of health (SDOH) screening in hospitalized pediatric patients and no studies comparing how screening results relate to population indices: Childhood Opportunity Index (COI) and Area Deprivation Index (ADI).

Methods: Patients transferred or admitted to the inpatient service from July 2020-Oct 2021 were administered a 14-question SDOH screening tool. Generalized estimation equation logistic regression models were used to compare length of stay (LOS), readmission rates, and 2-yr acute care utilization associations with social indices.

Results: 2454 (65%) admissions completed an SDOH screen—662 (27%) admissions were found to have a positive screen. Compared to the least deprived index quartile, patients in the highest index quartile had increased odds of having a positive screen (COI-OR:2.175, P< 0.001; ADI-OR: 2.122, P< 0.001). Using a 50th percentile index cut off for screening would miss >40% of positive SDOH screens. The ADI was associated with increased risk of LOS (RR: 1.043, P=0.008) and hospitalizations (OR: 1.031, P=0.003) but decreased risk of ED visits (OR: 0.967, P=0.023). Correlations between positive SDOH screen and COI did not meet statistical significance.

Conclusion: Social indices can be used as a low cost method of identifying target populations. However, while social indices correlate with patient specific SDOH screens, they miss identifying a significant number of patients with needs in low deprivation areas.