ICD-10 Z-Code Health-Related Social Needs and Increased Healthcare Utilization
Abstract
Introduction Health-related social needs are known drivers of health and health outcomes, yet work to date to examine health-related social needs using ICD-10 Z-codes remains limited. This study seeks to evaluate the differences in the prevalence of conditions as well as utilization and cost between patients with and without health-related social needs. Methods Using the 2017 Florida State Emergency Department and State Inpatient Databases, this study identified patients with documented health-related social needs using ICD-10 Z-codes. The prevalence ratio was calculated for 14 conditions that are the leading causes of mortality and economic costs. In addition, ratios for the median total number of negative health events and total annual costs between patients with health-related social needs and those without health-related social needs across these conditions were calculated. Data analysis was conducted in 2021. Results Of 4,477,772 patients, 46,081 (1.0%) had documented health-related social needs and had 4 times the negative health events and 9.3 times the total annual costs. Trends of increased negative health events and costs were seen across all examined conditions; patients with health-related social needs had 2.5-3.5 times the negative health events and 2-18 times greater total costs. The biggest difference in negative health events was seen in patients with unintentional injuries and depression and psychoses (3.5 times for patients with health-related social needs),…
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Prior studies using all-payer inpatient admission and EHR data observed that individuals with Z codes were younger or had higher prevalence of comorbidities.
“Prior studies using all-payer inpatient admission and EHR data observed that individuals with Z codes were younger or had higher prevalence of comorbidities23–25.”
From Documentation of individual-level social determinants of health among adults diagnosed with cancer in the United States (2025) · cites this paper as [25]
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- Authors
- Bensken, W. P., Alberti, P. M., Stange, K. C., Sajatovic, M., & Koroukian, S. M.
- Affiliations
- Case Western Reserve University (US)
- Association of American Medical Colleges (US)
- Case Comprehensive Cancer Center (US)
- University Hospitals of Cleveland (US)
- Corresponding author
- Bensken, Wyatt P.
- Venue
- American Journal of Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2022-04
- Volume
- 62
- Issue
- 4
- Pages
- e232-e241
- ISSN
- 0749-3797 (ISSN-L)
- OpenAlex
- W4200258009
- Cited by
- 58
- References
- 0
- Citations by year
- 2026: 11 · 2025: 19 · 2024: 12 · 2023: 13 · 2022: 3
- FWCI
- 3.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (P30CA043703)
- National Institute of Nursing Research (R15NR017792)
- National Institute of Dental and Craniofacial Research (UH3DE025487)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Keywords
- health-related social needs, health care utilization, health care costs, emergency department visits, hospitalization, unintentional injuries, depression, psychosis
- MeSH terms
- Emergency Service, Hospital, Humans, Patient Acceptance of Health Care, Retrospective Studies, Prevalence, Databases, Factual, Health Care Costs, International Classification of Diseases
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