Evidence mapPaperPMID 39760832Full record

ArticleThe journal of trauma and acute care surgery2025

National analysis of health-related social needs among adult injury survivors.

Alexandra H Hernandez, Nina M Clark, Erika Bisgaard, Deepika Nehra, Barclay T Stewart, Alexander Malloy, Eileen M Bulger, Joseph L Dieleman, Douglas Zatzick, John W Scott

Abstract read
In one paragraph

Article in The journal of trauma and acute care surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Alexandra H HernandezFrom the Department of Surgery (A.H.H., N.M.C., B.T.S.), Division of Trauma, Burn, and Critical Care Surgery, Department of Surgery (E.B., D.N., B.T.S., A.M., E.M.B., J.W.S.), and Department of Health Metrics Sciences (J.L.D., J.W.S.), Institute for Health Metrics and Evaluation, University of Washington; Psychiatry and Behavioral Sciences (D.Z.), University of Washington School of Medicine, Seattle, Washington.ORCID 0000-0002-4012-6164
Nina M Clark
Erika Bisgaard
Deepika Nehra
Barclay T Stewart
Alexander Malloy
Eileen M Bulger
Joseph L Dieleman
Douglas Zatzick

Funding

Insurance Coverage and Workforce Incentives to Improve Access to Surgical CareR01DK137466 · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2025 to 2025
$376k
AHRQ HHS K08 HS028672NIDDK NIH HHS R01 DK137466
6 · The paper itself

Abstract

backgroundDespite advances in trauma care, the effects of social determinants of health continue to be a barrier to optimal health outcomes. Health-related social needs (HRSNs), now the basis of a Centers for Medicare and Medicaid Services national screening program, may contribute to poor health outcomes, inequities, and low-value care, but the impact of HRSNs among injured patients remains poorly understood at the national level.

methodsUsing data from the nationally representative 2021 Medical Expenditure Panel Survey, injured patients were matched with uninjured controls via coarsened exact matching on age and sex. We then determined the prevalence of HRSNs based on core needs identified by Centers for Medicare and Medicaid Services: food, utilities, living situation, transportation, and personal safety. We used multivariable regression models to evaluate the association between HRSNs and health, delays in care, and emergency department visits.

resultsOverall, 43% of injured patients reported one or more HRSNs. Compared with uninjured controls, injured patients were more likely to have unmet needs in all five HRSN domains (adjusted odds ratio, 1.44-2.00; p < 0.05 for all). In stratified analyses, HRSNs were highest among patients with lower income (65.1%), those who identified as Non-Hispanic Black patients (61.3%), and patients with Medicaid (66.1%). Increasing number of HRSNs was associated with worse physical and mental health ( p < 0.05). Injured patients with three or more HRSNs were also more likely to delay care because of cost (adjusted odds ratio, 3.79; 95% confidence interval, 2.29-6.27) and had greater emergency department utilization (adjusted incidence rate ratio, 1.47; 95% confidence interval, 1.16-1.87).

conclusionIn this nationally representative study, nearly half of injured patients had one or more HRSNs. Greater numbers of HRSNs were associated with worse health outcomes, delayed care, and low-value care. As national screening for HRSNs is implemented, strategies to address these factors are needed and may serve to optimize health and health care utilization among injury survivors. LEVEL OF EVIDENCE: Prognostic and Epidemiological; Level III.

Indexed as

Health Services Needs and DemandNeeds AssessmentSocial Determinants of HealthSurvivorsWounds and InjuriesAdultAgedFemaleHumansMaleMiddle AgedUnited StatesYoung Adult

Identifiers

PMID39760832
PMCPMC13052385

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.