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Outcomes and Interventions for Health-related Social Needs in Colon and Rectal Surgery
Thomas E. Ueland MD1, Sara Myers MD1, Sing Chau Ng MS1, Olga Beresneva MD2, Samantha Rivard MD2, Jamie R Robinson MD PhD3,4, Jennifer S. Davids MD2 1 Boston Medical Center, Department of Surgery, Boston, MA 2 Boston Medical Center, Department of Surgery, Section of Colon and Rectal Surgery, Boston, MA 3 Vanderbilt University Medical Center, Department of Pediatric Surgery, Nashville, Tennessee 4 Vanderbilt University Medical Center, Department of Biomedical Informatics, Nashville, Tennessee
Background: Health-related social needs are individual-level barriers influencing clinical trajectories, though descriptions in colorectal populations are sparse. Methods: The cohort spanned two data sources: an urban hospital and the national All of Us Research Program. Participants underwent a colorectal operation with available information about social needs: food insecurity, housing instability, or a transportation barrier. Regression model outcomes were postoperative ED visits at 30- and 90- days and quality of life. Users of a hospital-based Food Pantry were identified, and outcomes were evaluated across groups of “No Food Insecurity”, “Food Insecurity: No Pantry Use”, and “Food Insecurity: Pantry Use”. Results: In the hospital and All of Us, 923 and 1,619 participants were included with 31.6% and 20.3% reporting a social need (Figure 1). The presence of a social need was associated with greater odds of ED visits and lower postoperative quality of life. Relative to patients without food insecurity, there was greater odds of 90-day ED visits among food insecure patients without Food Pantry use, but no association among Food Pantry users (Figure 2). Conclusion: In colorectal diseases, health-related social needs were common and associated with adverse outcomes. Targeted interventions may attenuate negative impacts of social barriers in the perioperative period.
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