Faculty, Staff and Student Publications

Language

English

Publication Date

1-1-2026

Journal

Journal of Primary Care & Community Health

DOI

10.1177/21501319261428865

PMID

41851838

PMCID

PMC13009944

PubMedCentral® Posted Date

3-18-2026

PubMedCentral® Full Text Version

Post-print

Abstract

Objective: This study evaluated differences in healthcare utilization among a pediatric primary care population following implementation of a universal social needs screening and referral program. It was hypothesized that emergency, sick, and hospitalization visits would decrease post-implementation, with stable or increased preventive care.

Methods: A retrospective, observational study was conducted using electronic health record data from 2 cohorts at different time periods at a large academic pediatric primary care clinic. The pre-implementation group included patients with a well-child visit from 08/2021 to 07/2022; the post-implementation group included patients from 09/2022 to 08/2023. Healthcare utilization measures of emergency department visits, hospitalizations, sick visits, and subsequent well-child visits were assessed from the index visit through the end of the group period. Differences in healthcare utilization were compared between cohorts using Mann-Whitney U (MW) tests, and associations of visit counts with social needs and care coordination referrals were examined using backwards-selected Zero-inflated Poisson regression models.

Results: The study included 3889 pre-implementation and 3813 post-implementation patients. Post-implementation patients had fewer emergency visits (≥1 visit: 15.5% vs 13.1%; MW P = .002) and sick visits (≥2 visits: 29.3% vs 24.3%; MW P < .001). Well-child visits did not differ (MW P = .981). Hospitalization rates were 2.5% pre-implementation and 2.0% post-implementation (MW P = .120).

Conclusions: Implementation of a universal social needs screening program was associated with improved patterns of pediatric healthcare utilization.

Keywords

Humans, Retrospective Studies, Male, Female, Child, Preschool, Child, Patient Acceptance of Health Care, Primary Health Care, Emergency Service, Hospital, Infant, Referral and Consultation, Hospitalization, Mass Screening, Needs Assessment, Adolescent, Electronic Health Records, social needs screening, social determinants of health, pediatric primary care, healthcare utilization, care coordination

Published Open-Access

yes

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