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Facilitators and Barriers to the Access of Social Services and Long Term Outcomes in Traumatically Injured Patients
Macie Gettings, BS
1,
2; Leah Froehle, MPH
1,
2; Anne Buck, MS, SPH
1,
2,
5; Saba Ilkhani, MD, MPH
3; Juan P. Herrera-Escobar, MD, MPH
3; G.A. Anderson, MD, MPH
3; J.O. Hwabejire, MD, MPH, MBBS
4; Sabrina E. Sanchez, MD, MPH
1,
2
1Boston Medical Center, Boston, MA, USA; 2Boston University Chobanian & Avedisian School of Medicine; 3Brigham And Women's Hospital, Center For Surgery And Public Health, Boston, MA, USA; 4Massachusetts General Hospital, Boston, MA, USA; 5Boston University School of Public Health
Background: Trauma patients face challenges post-injury that social services may alleviate. We aimed to identify characteristics associated with access of social services and how this impacts long-term outcomes.
Methods: Moderately to severely injured trauma patients from three level 1 trauma centers were included, 3/1/2022-12/31/2023. Data was obtained from trauma registries and telephone surveys 6-12 months post-injury. Social needs (food insecurity, unemployment, and functional disability), use of services, and long-term outcomes were patient reported.
Results: 839 patients reported a social need: 83 food insecurity (36.1% accessed services); 324 unemployment (31.8% accessed services); and 432 loss of functional ability (22.2% accessed services) (Table 1). Patients reporting unemployment who accessed services had a higher odds of financial problems than those who did not (OR=1.76, 95% CI=1.01-3.08, p=0.05). Patients with functional disability who accessed services had a lower ability to participate in social roles (coeff=-4.01, 95% CI=-7.53-0.50, p=0.03), and higher odds of post-traumatic stress disorder (PTSD) (OR=2.06, 95% CI=1.03-4.12, p=0.04), income loss (OR=2.17, 95% CI=1.18-3.98, p=0.01), and financial problems (OR=2.17, 95% CI=1.26-3.74, p=0.01) than those who did not.
Conclusion: Trauma patients reporting social needs access services at low rates, though patients with post-injury financial problems, social dysfunction, and PTSD are more likely to do so. Trauma patients with social needs may benefit from education and encouragement to utilize all the services available to them to optimize their recovery.
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