Collecting and using social needs data in health settings: A systematic review of the literature on health service utilization and costs

BACKGROUND: Social determinants of health significantly influence health outcomes and contribute to health inequities across populations. Systematic and routine collection of social needs data and its use to inform interventions within healthcare settings are proposed to reduce health services utilization and healthcare costs. This systematic review examines the impact of social needs data collection and use on health service utilization and healthcare costs. 

METHODS: Following PRISMA guidelines, we conducted a systematic review of studies published between January 2015 and February 2024. We included studies that reported on the collection and use of social needs data within healthcare settings in high-income countries. The review included randomized controlled trials, observational studies, quasi-experimental studies, qualitative studies, quality improvement studies, and mixed methods designs. Databases searched included Ovid MEDLINE, EMBASE, and Cochrane CENTRAL. The primary outcomes assessed were changes in health service utilization and healthcare costs. 

RESULTS: The review identified 35 relevant studies, predominantly from the United States. Interventions utilizing social needs data were implemented across various healthcare settings, including emergency departments, primary care, and inpatient facilities. Most studies reported reductions in emergency department visits (13/35) and hospitalizations (14/35) associated with collecting and using social needs data. Several studies demonstrated associated cost reductions, particularly in emergency department and hospitalization costs. However, the findings were mixed, with some studies reporting no significant changes or increased costs in certain areas, such as diagnostic testing and ambulatory care. 

CONCLUSIONS: Collecting and using social needs data within healthcare settings shows potential for reducing health service utilization and associated costs, particularly in targeted populations. The variability in outcomes suggests the need for context-specific approaches and further research to standardize reporting and understand the long-term impacts of these interventions. Standardized reporting and more robust study designs are needed to better understand these interventions' long-term impact, best implementation strategies, and scalability.