TY - JOUR
AU - C. Hau
AU - J. M. Grubber
AU - R. E. Ferguson
AU - W. C. Cushman
AU - A. Ishani
AU - P. A. Glassman
AU - C. A. Hynes
AU - S. M. Leatherman
A1 - 
AB - Background/Objectives: Identifying social determinants of health (SDOH) is important for effective clinical care. The ICD-10 introduced diagnostic categories to describe patients' adverse SDOH, but these codes are infrequently used across health systems, presenting challenges to implement data-driven healthcare. This study illustrates SDOH code utilization within a setting that is recognized as one of the largest integrated healthcare systems across the United States. Methods: Real-world clinical data were used with ICD-10 SDOH records obtained from 13,523 participants randomized into the Diuretic Comparison Project, a pragmatic trial conducted within the Veterans Affairs (VA) Health Care System between 2016 and 2022. SDOH code utilization was assessed across study years and among the specialized outpatient clinics. Results: A total of 29,305 SDOH records were identified, and 99.2% were from outpatient encounters. Social, mental, and housing care services generated the most SDOH records. Moreover, 3894 (28.8%) participants had at least one SDOH record during the 6-year period. Particular, 6.9% of participants had a record in the first year, and this increased to 7.6%, 8.1%, 8.7%, 9.6%, 10.3% in consecutive years. Conclusions: Our results suggest that SDOH code utilization has continued to improve within the VA, but SDOH assessments may not occur annually or be performed systematically within an integrated health setting. Much work is needed to develop universal screening tools and mandate routine SDOH evaluations. Nevertheless, a persistent increase in the counts of ICD-10 SDOH records shows a positive movement towards systematic documentation, supporting service providers to efficiently identify patients with adverse SDOH.
AD - Cooperative Studies Program Coordinating Center, VA Boston Healthcare System, Boston, MA 02111, USA.; Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA.; Medical Service, Memphis VA Medical Center, Memphis, TN 38105, USA.; Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA.; Minneapolis VA Healthcare System, Minneapolis, MN 55417, USA.; Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA.; Pharmacy Benefits Management Services, Department of Veterans Affairs, Washington, DC 20420, USA.; VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA.; David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA.; Department of Biostatistics, School of Public Health, Boston University, Boston, MA 02118, USA.
AN - 41228077
BT - Healthcare (Basel)
C5 - Healthcare Disparities
CP - 21
DA - Oct 27
DO - 10.3390/healthcare13212710
DP - NLM
ET - 20251027
IS - 21
JF - Healthcare (Basel)
LA - eng
N2 - Background/Objectives: Identifying social determinants of health (SDOH) is important for effective clinical care. The ICD-10 introduced diagnostic categories to describe patients' adverse SDOH, but these codes are infrequently used across health systems, presenting challenges to implement data-driven healthcare. This study illustrates SDOH code utilization within a setting that is recognized as one of the largest integrated healthcare systems across the United States. Methods: Real-world clinical data were used with ICD-10 SDOH records obtained from 13,523 participants randomized into the Diuretic Comparison Project, a pragmatic trial conducted within the Veterans Affairs (VA) Health Care System between 2016 and 2022. SDOH code utilization was assessed across study years and among the specialized outpatient clinics. Results: A total of 29,305 SDOH records were identified, and 99.2% were from outpatient encounters. Social, mental, and housing care services generated the most SDOH records. Moreover, 3894 (28.8%) participants had at least one SDOH record during the 6-year period. Particular, 6.9% of participants had a record in the first year, and this increased to 7.6%, 8.1%, 8.7%, 9.6%, 10.3% in consecutive years. Conclusions: Our results suggest that SDOH code utilization has continued to improve within the VA, but SDOH assessments may not occur annually or be performed systematically within an integrated health setting. Much work is needed to develop universal screening tools and mandate routine SDOH evaluations. Nevertheless, a persistent increase in the counts of ICD-10 SDOH records shows a positive movement towards systematic documentation, supporting service providers to efficiently identify patients with adverse SDOH.
PY - 2025
SN - 2227-9032 (Print); 2227-9032
ST - Social Determinants of Health ICD-10 Code Use by a Large Integrated Healthcare System
T1 - Social Determinants of Health ICD-10 Code Use by a Large Integrated Healthcare System
T2 - Healthcare (Basel)
TI - Social Determinants of Health ICD-10 Code Use by a Large Integrated Healthcare System
U1 - Healthcare Disparities
U3 - 10.3390/healthcare13212710
VL - 13
VO - 2227-9032 (Print); 2227-9032
Y1 - 2025
ER -