Unmet Social Needs and No-Show Visits in Primary Care in a US Northeastern Urban Health System, 2018-2019.

Am J Public Health

Kevin P. Fiori, Anna Flattau, and Sandra Braganza are with the Department of Family and Social Medicine, Albert Einstein College of Medicine (AECOM), Bronx, NY. Andrew Racine is with Montefiore Medical Group, Bronx. Kelly Lue and Molly Lauria are affiliated with the Community Health Systems Lab, Integrate Health, New York, NY. Caroline G. Heller and Colin D. Rehm are with the Office of Community and Population Health at Montefiore Health System, Bronx. Amanda Parsons is with MetroPlus Health Plan, New York.

Published: July 2020

To characterize the association between social needs prevalence and no-show proportion and variation in these associations among specific social needs. In this study, we used results from a 10-item social needs screener conducted across 19 primary care practices in a large urban health system in Bronx County, New York, between April 2018 and July 2019. We estimated the association between unmet needs and 2-year history of missed appointments from 41 637 patients by using negative binomial regression models. The overall no-show appointment proportion was 26.6%. Adjusted models suggest that patients with 1 or more social needs had a significantly higher no-show proportion (31.5%) than those without any social needs (26.3%), representing an 19.8% increase ( < .001). We observed a positive trend ( < .001) between the number of reported social needs and the no-show proportion-26.3% for those with no needs, 30.0% for 1 need, 32.1% for 2 needs, and 33.8% for 3 or more needs. The strongest association was for those with health care transportation need as compared with those without (36.0% vs 26.9%). We found unmet social needs to have a significant association with missed primary care appointments with potential implications on cost, quality, and access for health systems.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7362703PMC
http://dx.doi.org/10.2105/AJPH.2020.305717DOI Listing

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