Are hospitals capturing Social Determinants of Health in patient health records?
Social determinants of health (SDOH), such as education, employment, income and housing, can have an important influence on people’s health and health outcomes. But how consistently are these factors actually recorded when people are admitted to hospital? A new study published in the International Journal of Population Data Science (IJPDS), has found wide variation in the documentation of SDOH information in hospitals electronic medical records in Calgary, Alberta, Canada.
Researchers reviewed 10,659 hospital admissions records from four Calgary hospitals over a 5 year period, from 2017 to 2022. They assessed how often nine specific SDOH variables were documented: immigrant status, refugee status, ethnicity, marital status, employment status, financial strain, homelessness, living alone and gender identity.
The researchers found substantial differences in how frequently different types of SDOH information were recorded. Marital status was most frequently documented, followed by homelessness and whether someone lived alone. In contrast, refugee status, immigrant status and ethnicity were among the least frequently captured.
The study also found that some groups are more likely to have SDOH information recorded than others. Older patients and those with more complex healthcare needs, including people with longer hospital stays or a greater number of chronic conditions, were more likely to have SDOH data documented in their electronic records.
Collecting information about SDOH is important because factors such as housing, income, employment and social circumstances can contribute to differences in health outcomes. Having better patient-level information could help healthcare systems identify barriers faced by disadvantaged populations, inform the development of services and support more equitable care and resource allocation.
Although electronic medical records can capture social as well as medical information, relatively little research has examined how consistently SDOH variables are documented in Canadian hospitals. By conducting a comprehensive review of electronic patient charts, the researchers provide a clearer picture of which types of information are currently being captured and where important gaps remain. Understanding these gaps could help healthcare systems develop initiatives to improve the collection of SDOH information and identify which groups may be less likely to have their social circumstances recorded. Better documentation could, in turn, provide valuable information for understanding and addressing inequalities in healthcare. Lead author
Namneet Sandhu concludes that “Understanding current practice and the factors influencing documentation of social determinants of health in patient electronic charts is the first step towards improving the capture of these data in hospitals.”
Click here to read the full article
Namneet Sandhu (MPH), Epidemiologist, and Elliot Martin (PhD), Senior Data Scientist, Centre for Health Informatics, University of Calgary, Canada