Figure 2. Association Between Health-Related Social Need (HRSN) Burden and Rates of Hospital Stays or Emergency Department (ED) Visits.
Incident rate ratios are calculated from negative binomial regression models estimating the association between HRSNs and utilization measures. Models adjust for age, sex, race and ethnicity, disability status, dual eligibility status, and Elixhauser Comorbidity Index score, with hospital referral region fixed effects. For all incident rate ratios, the reference population is beneficiaries with no HRSNs. Hospital stays were an aggregate of inpatient admissions and observation stays. Avoidable hospital stays were defined using the Agency for Healthcare Research and Quality Prevention Quality Indicators definition.20 Avoidable ED visits were defined using the New York University ED visit algorithm and subsequent algorithm patch.21,22