NDLI: Are unmet health related social needs associated with emergency department utilization among Medicare beneficiaries?

Content Provider	Springer Nature : BioMed Central
Author	Abbott, Ethan E. Taylor, Shameeke Vargas-Torres, Carmen Petrozzo, Kevin Buckler, David G. Richardson, Lynne D. Zebrowski, Alexis M.
Abstract	Background Health-related social needs (HRSN) are increasingly recognized as important factors influencing healthcare outcomes and utilization. This study examined the association between unmet HRSNs and emergency department (ED) utilization among Medicare beneficiaries. Methods We conducted a retrospective, survey-weighted cohort analysis of the 2015–2016 Medicare Current Beneficiary Survey (MCBS) linked with Medicare fee-for-service claims. The study included beneficiaries aged ≥ 65 years enrolled in fee-for-service Medicare who completed the MCBS. The primary predictor was having ≥ 1 unmet HRSN (food insecurity, delaying care due to cost, or difficulty accessing medical care). Primary outcomes included an index ED visit (1 ED visit) and any ED revisit within one year (≥ 2 ED visits); hospital admission from these ED visits was a secondary outcome. We fit multivariable logistic regression models adjusted for demographic, socioeconomic, and clinical factors. Interactions were tested using adjusted Wald tests. Results Among 16,990 beneficiaries, 6.2% (n = 1,046) reported one or more unmet HRSNs. Within one year of completion of the survey, 27.7% (n = 4,702) had an 1 ED visit, with 9.03% of all beneficiaries (n = 1,535) requiring admission to the hospital. In adjusted analyses, beneficiaries with unmet HRSN had significantly higher odds of ≥ 2 ED visits (OR 1.47, 95% CI 1.12–1.91) compared to those without unmet HRSNs, but not for index ED visit. The oldest age category (85 + years) showed significantly increased odds of both index ED visits and revisits. Unmet HRSN were not significantly associated with risk of subsequent hospital admission for both index ED visit and ED revisit. Conclusion Self-reported unmet HRSNs were associated with significantly increased odds of ≥ 2 ED visits but not an 1 ED visit within one year of the MCBS survey. These findings highlight the importance of improved and standardized data collection of HRSNs to understand the impacts on ED utilization. Oldest age patients had increased odds of index ED visits and revisits. Further investigation should focus on strategies to reduce ED recidivism in vulnerable older populations.
Related Links	https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-025-12554-7.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	14726963
DOI	10.1186/s12913-025-12554-7
Journal	BMC Health Services Research
Issue Number	1
Volume Number	25
Language	English
Publisher	BioMed Central
Publisher Date	2025-03-31
Access Restriction	Open
Subject Keyword	Public Health Health Administration Health Informatics Nursing Research Medicare current beneficiary survey Health-related social needs Emergency department
Content Type	Text
Resource Type	Article
Subject	Health Policy

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

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