Quantifying social vulnerability and its impact on health care delivery, payment, and performance

SDOH and health-related social needs are known factors affecting health care delivery and equity. While several indices can direct our inquiries at a local population-based level, these should serve only to direct our attention further down to the individual level. We must begin actively incorporating the collection of individual SDOH and health-related social needs data into the EHR as a routine part of the patient encounter, not only because it is becoming mandated, but also because it should dictate how we deliver the most appropriate care to each patient. Surgical research directed at health care delivery should consider these data in a similar way to the contributions of medical comorbidities. Understanding how this impacts our benchmarking and payment is equally critical to improving how we deliver care and improve outcomes across the surgical subspecialties without penalizing those who provide the bulk of this care, such as those who provide emergency or safety-net care to patients.