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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
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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. |
format | Online Article Text |
id | pubmed-7960895 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
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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