Abstract: TH-PO714
Social Determinants and Health Care Utilization Among a CKD Population in North Philadelphia: An Exploratory, Mixed Methods Approach
Session Information
- Diversity and Equity in Kidney Health - I
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 800 Diversity and Equity in Kidney Health
Authors
- Sifontis, Nicole M., Temple University School of Pharmacy, Philadelphia, Pennsylvania, United States
- Lee, Jean, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
- Gillespie, Avrum, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
- Rabbitt, Colleen, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
- Constantinescu, Serban, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
Background
Patients with CKD exhibit multiple comorbidities, resulting in increased health care utilization and costs. Health disparities are common across the kidney disease spectrum resulting in poorer management of chronic illnesses. The starkest constrast in these disparities are seen based on social determinants like race and socioeconomic status. This project aims to better understand health disparities that drive health care utilization in patients with CKD who receive care at our institution.
Methods
This sequential mixed methods study identified the social determinants of health (SDoH) needs of patients with CKD at our institution. It explored available resources to address these determinants and barriers that limit access to services. Quantitative data were collected utilizing the Center for Medicare & Medicaid Services (CMS) Health-Related Social Needs (HRSN) screening tool to interview patients. Qualitative data were collected via a focus group session with community health workers (CHWs) employed by the institution, to identify faciliators and barriers to the social needs established by the quantitative analysis.
Results
34 patients with CKD were interviewed. Food insecurity (29.4%), reliable transportation (26.5%) and utility needs (23.5%) were the most common social determinants noted. Bivariate analyses revealed a statistically significant relationship between living situation and food insecurity; p=0.0031, living situation and utility needs; p=0.0094, and transportation and food insecurity, p=0.0227. CHWs expressed the importance of building trust with their patients, engaging community-based partners to assist with social needs, and robust patient engagement as important facilitators of SDoH. Reported barriers to connecting patients to supportive services included: inability to contact patients readily, provider burn out, time constraints, and the challenges of addressing overlapping social needs simultaneously.
Conclusion
These data highlight the need for better screening tools and more efficient care models that would allow the time and resources necessary to complete these tasks. These pilot data will help inform a systems-based approach to improving health equity among the CKD population who receive care at our center.