Association Between ICD-10 Codes for Social Needs and Subsequent Emergency and Inpatient Use.
Med Care
; 62(1): 60-66, 2024 Jan 01.
Article
em En
| MEDLINE
| ID: mdl-37962423
ABSTRACT
BACKGROUND:
International Classification of Diseases, 10th revision Z codes capture social needs related to health care encounters and may identify elevated risk of acute care use.OBJECTIVES:
To examine associations between Z code assignment and subsequent acute care use and explore associations between social need category and acute care use. RESEARCHDESIGN:
Retrospective cohort study.SUBJECTS:
Adults continuously enrolled in a commercial or Medicare Advantage plan for ≥15 months (12-month baseline, 3-48 month follow-up).OUTCOMES:
All-cause emergency department (ED) visits and inpatient admissions during study follow-up.RESULTS:
There were 352,280 patients with any assigned Z codes and 704,560 sampled controls with no Z codes. Among patients with commercial plans, Z code assignment was associated with a 26% higher rate of ED visits [adjusted incidence rate ratio (aIRR) 1.26, 95% CI 1.25-1.27] and 42% higher rate of inpatient admissions (aIRR 1.42, 95% CI 1.39-1.44) during follow-up. Among patients with Medicare Advantage plans, Z code assignment was associated with 42% (aIRR 1.42, 95% CI 1.40-1.43) and 28% (aIRR 1.28, 95% CI 1.26-1.30) higher rates of ED visits and inpatient admissions, respectively. Within the Z code group, relative to community/social codes, socioeconomic Z codes were associated with higher rates of inpatient admissions (commercial aIRR 1.10, 95% CI 1.06-1.14; Medicare Advantage aIRR 1.24, 95% CI 1.20-1.27), and environmental Z codes were associated with lower rates of both primary outcomes.CONCLUSIONS:
Z code assignment was independently associated with higher subsequent emergency and inpatient utilization. Findings suggest Z codes' potential utility for risk prediction and efforts targeting avoidable utilization.
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Base de dados:
MEDLINE
Assunto principal:
Medicare Part C
/
Pacientes Internados
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article