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Member Research & Reports

Member Research & Reports

South Florida: Keeping Vulnerable Populations Out of the Hospital

The conditions in which you live, learn, work and play can all affect your overall health, according to the Centers for Disease Control and Prevention (CDC).

The University of South Florida College of Public Health doctoral student Mr. Nnadozie Emechebe is lead author on a recent study published in The American Journal of Managed Care examining how the social determinants of health impacted vulnerable populations being admitted to the hospital for care.

In, “Passive Social Health Surveillance and Inpatient Readmissions,” Mr. Emechebe looked at how call-center referral data managed by WellCare Health Plans — a managed care organization — to determine if there was an association between self-reported social needs and hospital readmissions.

“To provide some context, WellCare Health Plans provide referrals to community-based social service organizations to individuals who contact the call center and report a social need,” Mr. Emechebe said. “These social needs include financial assistance to pay for rent and utilities, food programs, assistance with medication, housing support, free or low-cost transportation, among others.”

The study attempted to highlight the potential of utilizing call-center referral data, a system Mr. Emechebe said we like to call passive social health surveillance, as a compliment to social needs screening to identify individuals with unmet social needs.

According to Mr. Emechebe, health care plans receive a medical claim each time its members interact with the health care system.

This study linked referral and claims data for 19,817 individuals to examine the odds of inpatient readmissions for individuals with self-identified social needs, such as food and housing insecurity, compared with those without self-identified needs.

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