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

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.