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Toward Understanding Social Needs Among Primary Care Patients With Uncontrolled Diabetes

INTRODUCTION/OBJECTIVES: Uncontrolled diabetes can lead to major health complications, and significantly contributes to diabetes-related morbidity, mortality, and healthcare costs. Few studies have examined the relationship between unmet social needs and diabetes control among predominantly Black an...

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Autores principales: Chambers, Earle C., McAuliff, Kathleen E., Heller, Caroline G., Fiori, Kevin, Hollingsworth, Nicole
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7960895/
https://www.ncbi.nlm.nih.gov/pubmed/33467953
http://dx.doi.org/10.1177/2150132720985044
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author Chambers, Earle C.
McAuliff, Kathleen E.
Heller, Caroline G.
Fiori, Kevin
Hollingsworth, Nicole
author_facet Chambers, Earle C.
McAuliff, Kathleen E.
Heller, Caroline G.
Fiori, Kevin
Hollingsworth, Nicole
author_sort Chambers, Earle C.
collection PubMed
description INTRODUCTION/OBJECTIVES: Uncontrolled diabetes can lead to major health complications, and significantly contributes to diabetes-related morbidity, mortality, and healthcare costs. Few studies have examined the relationship between unmet social needs and diabetes control among predominantly Black and Hispanic patient populations. METHODS: In a large urban hospital system in the Bronx, NY, 5846 unique patients with diabetes seen at a primary care visit between April 2018 and December 2019 completed a social needs screener. Measures included diabetes control (categorized as Hemoglobin (Hb) A1c <9.0 as controlled and Hb A1C ≥9.0 as uncontrolled), social needs (10-item screen), and demographic covariates, including age, sex, race/ethnicity, insurance status, percentage of block-group poverty, patient’s preferred language, and the Elixhauser Comorbidity Index. RESULTS: Twenty-two percent (22%) of the patient sample had at least 1 unmet social need, and the most prevalent unmet social needs were housing issues (including housing quality and insecurity), food insecurity, and lack of healthcare transportation. Logistic regression analysis showed a significant relationship between social needs and uncontrolled diabetes, with more social needs indicating a greater likelihood of uncontrolled diabetes (Adjusted Odds Ratio (AOR) for ≥3 needs: 1.59, 95% CI: 1.26, 2.00). Of the patients with most frequently occurring unmet social needs, lack of healthcare transportation (AOR: 1.54, 95% CI: 1.22, 1.95) and food insecurity (AOR: 1.50, 95% CI: 1.19, 1.89) had the greatest likelihood of having uncontrolled diabetes, after adjusting for covariates. CONCLUSION: Unmet social needs appear to be linked to a greater likelihood of uncontrolled diabetes. Implications for healthcare systems to screen and address social needs for patients with diabetes are discussed.
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spelling pubmed-79608952021-03-29 Toward Understanding Social Needs Among Primary Care Patients With Uncontrolled Diabetes Chambers, Earle C. McAuliff, Kathleen E. Heller, Caroline G. Fiori, Kevin Hollingsworth, Nicole J Prim Care Community Health Original Research INTRODUCTION/OBJECTIVES: Uncontrolled diabetes can lead to major health complications, and significantly contributes to diabetes-related morbidity, mortality, and healthcare costs. Few studies have examined the relationship between unmet social needs and diabetes control among predominantly Black and Hispanic patient populations. METHODS: In a large urban hospital system in the Bronx, NY, 5846 unique patients with diabetes seen at a primary care visit between April 2018 and December 2019 completed a social needs screener. Measures included diabetes control (categorized as Hemoglobin (Hb) A1c <9.0 as controlled and Hb A1C ≥9.0 as uncontrolled), social needs (10-item screen), and demographic covariates, including age, sex, race/ethnicity, insurance status, percentage of block-group poverty, patient’s preferred language, and the Elixhauser Comorbidity Index. RESULTS: Twenty-two percent (22%) of the patient sample had at least 1 unmet social need, and the most prevalent unmet social needs were housing issues (including housing quality and insecurity), food insecurity, and lack of healthcare transportation. Logistic regression analysis showed a significant relationship between social needs and uncontrolled diabetes, with more social needs indicating a greater likelihood of uncontrolled diabetes (Adjusted Odds Ratio (AOR) for ≥3 needs: 1.59, 95% CI: 1.26, 2.00). Of the patients with most frequently occurring unmet social needs, lack of healthcare transportation (AOR: 1.54, 95% CI: 1.22, 1.95) and food insecurity (AOR: 1.50, 95% CI: 1.19, 1.89) had the greatest likelihood of having uncontrolled diabetes, after adjusting for covariates. CONCLUSION: Unmet social needs appear to be linked to a greater likelihood of uncontrolled diabetes. Implications for healthcare systems to screen and address social needs for patients with diabetes are discussed. SAGE Publications 2021-01-19 /pmc/articles/PMC7960895/ /pubmed/33467953 http://dx.doi.org/10.1177/2150132720985044 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Chambers, Earle C.
McAuliff, Kathleen E.
Heller, Caroline G.
Fiori, Kevin
Hollingsworth, Nicole
Toward Understanding Social Needs Among Primary Care Patients With Uncontrolled Diabetes
title Toward Understanding Social Needs Among Primary Care Patients With Uncontrolled Diabetes
title_full Toward Understanding Social Needs Among Primary Care Patients With Uncontrolled Diabetes
title_fullStr Toward Understanding Social Needs Among Primary Care Patients With Uncontrolled Diabetes
title_full_unstemmed Toward Understanding Social Needs Among Primary Care Patients With Uncontrolled Diabetes
title_short Toward Understanding Social Needs Among Primary Care Patients With Uncontrolled Diabetes
title_sort toward understanding social needs among primary care patients with uncontrolled diabetes
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7960895/
https://www.ncbi.nlm.nih.gov/pubmed/33467953
http://dx.doi.org/10.1177/2150132720985044
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