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J Pediatr Intensive Care
DOI: 10.1055/s-0043-1774719
Original Article

A Multicenter Retrospective Evaluation of Social Determinant of Health Z Code Usage among Pediatric Patients with Critical Care Visits during Pediatric Critical Care

Lisa Yoder
1   Pennsylvania State University College of Medicine, Hershey, Pennsylvania, United States
,
Duane Williams
2   Division of Pediatric Critical Care Medicine, Department of Pediatrics, Penn State Health Children's Hospital, Hershey, Pennsylvania, United States
,
Zizhong Tian
3   Division of Biostatistics and Bioinformatics, Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, United States
,
Chan Shen
4   Department of Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, United States
5   Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, United States
,
Shouhao Zhou
5   Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, United States
,
Neal J. Thomas
2   Division of Pediatric Critical Care Medicine, Department of Pediatrics, Penn State Health Children's Hospital, Hershey, Pennsylvania, United States
5   Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, United States
,
Conrad Krawiec 
2   Division of Pediatric Critical Care Medicine, Department of Pediatrics, Penn State Health Children's Hospital, Hershey, Pennsylvania, United States
› Author Affiliations Funding The project described was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through grant UL1 TR002014 including TriNetX network access. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Abstract

Social determinants of health (SDOH) diagnostic codes may facilitate the deployment of appropriate resources to improve patient outcomes, but their use in critically ill pediatric populations is unknown. Our study aims to examine SDOH codes usage hypothesizing that it is underutilized. This is a retrospective observational cohort study utilizing the TriNetX electronic health record database. We included subjects aged less than 18 years with critical care services billing codes and analyzed demographics, International Classification of Diseases, 10th edition diagnostic codes, and SDOH diagnostic codes 1 year before, during (7 days before and after), and 1 year after critical care services. We included 73,444 subjects (1,150 [1.6%] SDOH codes present during; 1,015 [1.4%] 1 year before; and 1,710 [2.3%] 1 year after critical care services) from 39 health care organizations. The most common SDOH diagnostic code utilized was “problems related to upbringing” (50.4%). SDOH diagnostic codes were consistently significantly associated with diagnostic codes related to seizures. SDOH diagnostic code presence was infrequent in critically ill pediatric patients. These findings may indicate not only the underutilization of SDOH diagnostic code but also the underrepresentation of SDOH prevalence in this patient population.

Keywords

critical care - International Classification of Diseases - pediatrics - social determinants of health


Publication History

Received: 28 June 2023

Accepted: 15 August 2023

Article published online:
19 September 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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