TOPLINE:
Social risk factors, particularly lack of financial resources and unmet transportation needs, were associated with an increased cost of care.
METHODOLOGY:
- Researchers conducted a retrospective study to assess the effect of various social factors on cost of care.
- The analysis included 410,624 adult patients (mean age, 51.1 years; 54.2% women; 92.0% White) enrolled in 689 family medicine clinics in Iowa, Minnesota, and Wisconsin in 2022.
- Patients completed questionnaires evaluating five social risk domains: financial resources, food insecurity, intimate partner violence, transportation, and housing instability.
- Total cost of care was calculated from billing data that included visits to clinics, specialty centers, and the emergency department, hospitalizations, and readmissions; total costs were reported as standardized z scores.
- Medical complexity was assessed using the Johns Hopkins Adjusted Clinical Group System, and individual socioeconomic status was measured using the Housing-Based Socioeconomic Status index.
TAKEAWAY:
- Patients with a high social risk had higher mean cost z scores, with lack of financial resources showing a mean cost z score of 0.38 for high-risk patients and 0.11 for low-risk patients, and unmet transportation needs demonstrating a mean cost z score of 0.45 for high-risk patients and 0.12 for low-risk patients.
- Cost z scores increased with increasing age and greater medical complexity, and they were similar across all quartiles of socioeconomic status.
- In an adjusted analysis, only food insecurity and intimate partner violence remained associated with the cost of care.
IN PRACTICE:
“To help decrease the high cost of patient care, more work is needed to determine how to consistently and efficiently collect patient and population social risk factor data so that the best approaches to decrease these risks can be determined,” the authors of the study wrote.
SOURCE:
The study was led by Matthew E. Bernard of the Department of Family Medicine at Mayo Clinic in Rochester, Minnesota. It was published online on March 31, 2026, in Journal of Primary Care & Community Health.
LIMITATIONS:
The study relied on self-reported data on social risk factors. The patient population was racially homogenous. Highly vulnerable populations, such as individuals experiencing homelessness, were not included.
DISCLOSURES:
The study received funding from the Department of Family Medicine at Mayo Clinic. The authors disclosed having no relevant conflicts of interest related to this research.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
