Background <p>External incentives increasingly encourage hospitals to address health-related social needs, yet limited evidence exists about whether social needs interventions are associated with quality indicators like potentially preventable admissions.</p> Objective <p>We analyze whether four hospital interventions—meal delivery, transportation to health services, mobile clinics, and community-oriented violence prevention programs—are associated with potentially preventable hospitalizations.</p> Design <p>Cross-sectional analysis of survey-based and claims-based data.</p> Participants <p>In total, 813 hospitals from 14 states, representing 6,003,739 adult all-payer hospital admissions.</p> Approach <p>This study merged 2017 Healthcare Cost Utilization Project State Inpatient Databases with 2017 American Hospital Association survey data. Generalized linear models for each of the four interventions were separately estimated to assess the association with potentially preventable hospitalizations, controlling for hospital and patient characteristics. Sensitivity analyses restricted regression modeling to adult Medicaid and Medicare beneficiaries.</p> Key Results <p>A minority (13%) of hospital admissions were potentially preventable. 24% of hospitals offered transportation to health services, 16% offered mobile clinic services, 16% offered violence prevention programs, and 9% offered meal delivery. In adjusted analyses, hospital meal delivery was associated with 1.1% lower predicted probability of a potentially preventable hospitalization (95% confidence interval (CI) −2.1% to −0.1%), with a stronger relationship among Medicaid beneficiaries (−2.3%, 95% CI −3.5% to −1.0%). Associations for other social needs interventions were not statistically significant.</p> Conclusions <p>Hospital meal delivery was associated with significantly lower probability of potentially preventable hospitalizations, with larger effects for Medicaid beneficiaries. Meal delivery may support hospital quality. More nuanced understanding about the reach of social needs interventions is needed to further&#xa0;examine the impact of these hospital-based services on patient outcomes.</p> Visual Abstract <p></p>

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Association of Hospital-Based Social Needs Interventions with Potentially Preventable Admissions

  • Margae J. Knox,
  • Amanda L. Brewster,
  • Jennifer Ahern,
  • Stephen M. Shortell,
  • Emily L. Hague,
  • Hector P. Rodriguez

摘要

Background

External incentives increasingly encourage hospitals to address health-related social needs, yet limited evidence exists about whether social needs interventions are associated with quality indicators like potentially preventable admissions.

Objective

We analyze whether four hospital interventions—meal delivery, transportation to health services, mobile clinics, and community-oriented violence prevention programs—are associated with potentially preventable hospitalizations.

Design

Cross-sectional analysis of survey-based and claims-based data.

Participants

In total, 813 hospitals from 14 states, representing 6,003,739 adult all-payer hospital admissions.

Approach

This study merged 2017 Healthcare Cost Utilization Project State Inpatient Databases with 2017 American Hospital Association survey data. Generalized linear models for each of the four interventions were separately estimated to assess the association with potentially preventable hospitalizations, controlling for hospital and patient characteristics. Sensitivity analyses restricted regression modeling to adult Medicaid and Medicare beneficiaries.

Key Results

A minority (13%) of hospital admissions were potentially preventable. 24% of hospitals offered transportation to health services, 16% offered mobile clinic services, 16% offered violence prevention programs, and 9% offered meal delivery. In adjusted analyses, hospital meal delivery was associated with 1.1% lower predicted probability of a potentially preventable hospitalization (95% confidence interval (CI) −2.1% to −0.1%), with a stronger relationship among Medicaid beneficiaries (−2.3%, 95% CI −3.5% to −1.0%). Associations for other social needs interventions were not statistically significant.

Conclusions

Hospital meal delivery was associated with significantly lower probability of potentially preventable hospitalizations, with larger effects for Medicaid beneficiaries. Meal delivery may support hospital quality. More nuanced understanding about the reach of social needs interventions is needed to further examine the impact of these hospital-based services on patient outcomes.

Visual Abstract