Prevalence of health-related social needs: Inpatient versus ambulatory pediatric populations

Objective: To compare the prevalence of unmet health-related social needs (HRSNs) among pediatric patients in ambulatory and inpatient settings within a tertiary children's hospital in Bronx, New York. 

Study design: This was a retrospective study of patients ≤20 years old who were screened for unmet HRSNs between November 1, 2023, and November 30, 2024. We compared inpatient and ambulatory pediatric samples using unadjusted and adjusted logistic regression models. 

Results: Overall, 29 233 patients were screened for HRSNs during the study period, with 25 909 (88.6%) patients screened in ambulatory settings and 3324 (11.4%) in inpatient units. The prevalence of unmet HRSNs was 12.6% in the ambulatory setting and 28.1% in the inpatient setting. Hospitalized patients had greater odds (aOR 2.41, 95% CI 2.20-2.63) of reporting at ≥1 unmet HRSNs compared with ambulatory patients. Hospitalized patients also demonstrated greater odds of reporting needs within each individual HRSNs domains. Within the inpatient sample, those 12-17 years of age had lower odds of unmet HRSNs than patients 0-5 years of age (aOR 0.75, 95% CI 0.61-0.92). Those who spoke Spanish (aOR 1.80, 95% CI 1.49-2.19) or identified their race and ethnicity as Hispanic (aOR 2.24, 95% CI 1.31-3.81), Non-Hispanic Black (aOR 2.48, 95% CI 1.45-4.25), or other (aOR 1.82, 95% CI 1.02-3.25) had greater odds of unmet HRSNs than English-speaking and Non-Hispanic White patients, respectively. 

Conclusions: Within the study, children who were hospitalized were more likely to have unmet HRSNs compared with patients who were ambulatory. Inpatient focused interventions are needed to support hospitalized families.