(810) Social Needs Resource Provision in Critically Ill Children May Reduce Hospital Readmissions

Introduction: Critically ill children have higher risk of health disparities which may be worsened during hospitalizations. Inpatient social workers can address health disparities by providing emotional support and social resources (SR). We described the characteristics of patients receiving SR during their PICU hospitalizations. We hypothesized children receiving SR would have fewer 6-month hospital readmissions.

Methods: A single-center retrospective study of all PICU encounters January 1, 2023-September 30, 2023. There were no set criteria or screening to determine social work involvement. Demographics and hospitalization characteristics associated with resource provision were described. To analyze the effect of social work resource provision on readmissions, the cohort was matched 1:1 by nearest-neighbor propensity for resource administration on demographics, illness severity, and length of stay.

Results: There were 1,036 PICU hospitalizations. 706 (68%) met with a PICU social worker and 344 (33.2%) received at least 1 SR. Food resources were provided most frequently, to 235 (22.7%) children, followed by housing resources to 138 (13.3%). Children who received resource(s) were younger (3.0 [0.8-12.0] years vs. 5.0 [1.7-13.0] years, p < 0.001), had a higher proportion of complex chronic conditions (70.3% vs. 59.4%, p < 0.001), public insurance (70.6% vs, 61.1% p < 0.001), and lived in zip-codes with lower median household income ($54,958 [$46,738-$66,810] vs. $53,316 [$41,260-$64,729], p = 0.009). These children had increased severity of illness (PELOD-2 1 [0-10] vs. 10 [0-11] p < 0.001, higher mortality (4.8% vs. 1.3%, p < 0.001) and higher hospital cost ($37,673 [$15,078.5-$81,990] vs. $16,510 [$9,556-$35,094] p < 0.001). There were 890 (85.9%) PICU survivors with complete 6-month follow up data for propensity matching, of whom 418 were matched. After matching, children with social resource provision were less likely to be readmitted within 6 months (marginal risk ratio 0.689 [95% CI 0.537-0.884]).

Conclusions: Critically ill children are at high risk for social needs on presentation to the PICU. Providing social needs resources during PICU hospitalization may reduce readmission rates.