Social determinants linked to provision of primary care
Alan Katz, M.B.Ch.B., from the University of Manitoba in Canada, and colleagues defined 11 social complexity factors using administrative data on poverty, mental health, newcomer status, and involvement in the justice system and measured their distribution among primary care patients who made at least three visits to clinicians during 2010 to 2013. The quality of care received by patients with zero to five or more social complexity factors was compared using 26 primary care indicators.
The researchers found that 54 percent of the 626,264 primary care patients were living with at least one social complexity factor; 4 percent were living with five or more. There was a strong correlation for social complexity factors with poorer outcomes with respect to primary care indicators for prevention (e.g., breast cancer screening: odds ratio, 0.77), chronic disease management (e.g., diabetes management: odds ratio, 0.86); geriatric care (e.g., benzodiazepine prescriptions: odds ratio, 1.63), and health services use (e.g., ambulatory visits: odds ratio, 1.09).
"Our findings provide insight into the social needs of primary care populations, and may support the development of focused interventions to address social complexity in primary care," the authors write.
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