Examining the Association Between Social Needs and Care Gap Closure Among Older Adults Receiving Dental Care

David M. Mosen PhD, MPH , Matthew P. Banegas PhD, MPH , Daniel J. Pihlstrom DDS , Erin M. Keast MPH , John F. Dickerson PhD , Jeffrey L. Fellows PhD
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Abstract

Introduction

The authors of this study sought to (1) describe the prevalence of social needs and (2) determine whether social needs were associated with closure of care gaps among patients aged ≥65 years seeking dental care.

Methods

In this retrospective cross-sectional study, the authors identified 754 Kaiser Permanente Northwest patients aged ≥65 years who completed an index dental visit; had at least 1 of 23 preventive care gaps (e.g., flu vaccination) or disease management care gaps (e.g., diabetes HbA1c screening test) documented in their medical record; and had completed a social needs assessment through survey evaluating financial strain, food insecurity, housing needs, social isolation, and transportation needs. The authors described the prevalence of social needs at the index visit and then used logistic regression to evaluate the association between the number of social needs (0, 1, ≥2) and closure of all care gaps over the following 60 days (yes versus no), adjusting for patient characteristics. Identification and closure of care gap were assessed through Kaiser Permanente Northwest's Panel Support Tool.

Results

Approximately 28% of patients reported ≥1 social needs. The prevalence of social needs was as follows: social isolation, 13.7%; financial strain, 11.3%; food insecurity, 7.7%; transportation needs, 5.4%; and housing needs, 3.3%. Those with 1 social need were more likely to close care gaps than those with no social needs (OR=1.82, 95% CI=1.17, 2.85). No significant association was found with care gap closure among those with ≥2 versus zero social needs.

Conclusions

The prevalence of social needs was nearly 30% among patients aged ≥65 years with dental and medical coverage. Patients with 1 social need were more likely than those with no social needs to close all care gaps after their visit.

研究接受牙科护理的老年人的社会需求与护理差距缩小之间的关系
方法在这项回顾性横断面研究中,作者确定了 754 名年龄≥65 岁的 Kaiser Permanente Northwest 患者,这些患者完成了一次牙科就诊;医疗记录中记录了 23 项预防性护理缺口(如流感疫苗接种)或疾病管理护理缺口(如糖尿病 HbA1c 筛查测试)中的至少一项;并通过调查完成了社会需求评估,评估内容包括经济压力、食品安全、社会需求和健康状况、流感疫苗接种)或疾病管理护理缺口(如糖尿病 HbA1c 筛查测试);并通过调查完成了社会需求评估,评估内容包括经济压力、食品不安全、住房需求、社会隔离和交通需求。作者描述了指标就诊时社会需求的普遍性,然后使用逻辑回归评估了社会需求数量(0、1、≥2)与随后 60 天内所有护理差距的缩小(是与否)之间的关联,并对患者特征进行了调整。结果约 28% 的患者报告的社会需求≥1。社会需求的发生率如下:社会孤立,13.7%;经济压力,11.3%;食品不安全,7.7%;交通需求,5.4%;住房需求,3.3%。与没有社会需求的人相比,有一种社会需求的人更有可能缩小护理差距(OR=1.82,95% CI=1.17,2.85)。在牙科和医疗保险范围内,年龄≥65 岁的患者中社会需求的发生率接近 30%。有一项社会需求的患者比没有社会需求的患者更有可能在就诊后弥补所有护理缺口。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
AJPM focus
AJPM focus Health, Public Health and Health Policy
CiteScore
0.50
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