Decoding social determinants of health

The conversion of diagnostic coding from the ninth to the 10th revision of the International Classification of Diseases in October 2015 created an opportunity for health care providers to identify, diagnose and document patients with social complexity in a uniform diagnostic and billing data system. Standardizing the practice of diagnosing patients with the included social determinants of health (SDOH) codes was made easier in February 2018 when provisions were made by the ICD-10 Cooperating Parties to enable nonphysician providers, such as nurses, social workers, case managers, community health workers and discharge planners, to diagnose social factors.

The aim of this policy brief is threefold. First, the brief evaluates the frequency and consistency of SDOH coding for Missouri patients. Second, it identifies the types of SDOH codes being used and the characteristics of socially complex patients compared to the larger population. And third, it characterizes the predictive properties of the SDOH codes in standard risk adjustment models of hospital super-utilization in Missouri during 2017.