Engagement in a social needs navigation program and healthcare utilization in pediatric primary care

Background and Objectives: Evidence for social needs interventions on resource linkage has grown over the past decade. Though social and economic needs predict healthcare utilization, few studies have assessed social needs interventions on these outcomes. The objective of this study was to examine the association between enrollment in a clinic-based social needs program on subsequent well child visit (WCV) attendance and emergency department (ED) use in two primary care clinics. METHODS: A retrospective cohort study was conducted of patients in two clinics referred to a social risk screening and navigation program between June-August 2018. We compared healthcare utilization over the subsequent 12 months for those who completed a full intake and received resource navigation (enrolled) to those referred (not enrolled). Logistic regression was used to assess the association between enrollment with WCV attendance and ED visits. RESULTS: During the study period, of the 969 patients referred to the program, 761 were enrolled across the two clinics. At both sites, the majority of enrolled patients had high WCV attendance post intervention, (Site A: 81.6%, Site B: 71.4%). High WCV attendance for non-enrolled but referred patients was significantly lower (Site A: 52.7%, Site B: 35.0%). Enrolled participants were significantly more likely to have high WCV attendance than non-enrolled patients, adjusting for pre-intervention utilization (Site A aOR: 5.83, Site B aOR: 4.20). There were no significant differences in emergency department use at either clinic.