Authors:
Xavier C Cortez, Emily Finlayson, Susan Smith, Catherine Lau, Ralph Gonzales, Thomas Chi, Harnoor Jolly

Background:
Prolonged length of stay (LOS) after surgery has been shown to worsen patient recovery and utilize health system resources unnecessarily. Logistical and social support barriers to optimizing surgical care have been under-examined. The primary objective of this study was to implement a social needs screening tool amongst patients undergoing surgery and measure its impact on LOS and total direct cost.

Methods:
This was a single institution prospective cohort study where staff members utilized a social needs screening tool for patients undergoing surgery in seven surgical departments (Plastics, Vascular, Neurosurgery, OHNS, Ophthalmology, Orthopedics, Urology) from July 1, 2020 to June 30, 2021. Patient ability to obtain mandatory COVID testing, transportation to and from the hospital for surgery, availability of a post-operative caregiver, and current mood were queried during screening. Referral to Social Work Services was conducted if the patient reported a resource deficiency. LOS and total direct cost were collected for each encounter and compared to a control cohort of patients from the same departments from January 1, 2019 to February 28, 2020 that did not undergo social needs screening.

Results:
3284 patients were screen-eligible and were compared to 3360 control encounters. 190 patients screened positive and were provided social work support. There were no significant differences in age, gender, and race between the screened and control cohorts. Screen-positive patients were more likely to have government insurance as their primary payor (p<0.05). Median and average LOS was lower in the intervention (1, 2.67 days) compared to the control cohort (2, 3.58 days). Median and average direct cost was lower in the intervention ($11,661; $20,406) compared to the control ($18,193; $30,084) cohort.

Conclusion:
The implementation of a social needs screening tool to proactively address logistical barriers to care reduces LOS and total direct cost for surgical patients, optimizing comprehensive healthcare delivery.

A social needs screening tool facilitates reduced length of stay and total encounter cost for surgical patients

Health Systems Science | Advocacy and Health Equity / Public Health / Data Science Health Systems

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A social needs screening tool facilitates reduced length of stay and total encounter cost for surgical patients

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