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Cited by 32Medical Coding and Health InformationHealth disparities and outcomesBlood Pressure and Hypertension Studies

Social Determinants of Health–Related Z Codes and Health Care Among Patients With Hypertension

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Lee, Jun Soo, MacLeod, Kara E., Kuklina, Elena V., Tong, Xin, Jackson, Sandra L.·2023·AJPM Focus
DOI 10.1016/j.focus.2023.100089PMC PMC10546517
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Abstract

Introduction: Tracking social needs can provide information on barriers to controlling hypertension and the need for wraparound services. No recent studies have examined ICD-10-CM social determinants of health-related Z codes (Z55-Z65) to indicate social needs with a focus on patients with hypertension. Methods: =146,484). Both the proportion of patients and healthcare encounters or visits with social determinants of health-related Z code were summarized annually. Patient and visit characteristics were summarized for 2019. Results: In 2020, the highest annual documentation of social determinants of health-related Z codes was among Medicaid beneficiaries (3.02%, 0.46% commercial, 0.42% Medicare Supplement); documentation was higher among inpatient than among outpatient visits for all insurance types. Z63 (related to primary support group) was more common among commercial and Medicare Supplement beneficiaries, and Z59 (housing and economic circumstances) was more common among Medicaid beneficiaries. The 2019 total unadjusted medical expenditures were 1.85, 1.78, and 1.61 times higher for those with social determinants of health-related Z code than for those without commercial, Medicare Supplement, and Medicaid, respectively. Patients with social determinants of health-related Z code also had higher proportions of diagnosed chronic conditions. Among Medicaid beneficiaries, differences in the presence of social determinants of health-related Z code by race or ethnicity were observed. Conclusions: Although currently underreported, social determinants of health-related Z codes provide an opportunity to integrate social and medical data and may help decision makers understand the need for additional services among individuals with hypertension.

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  • Our findings are consistent with prior published findings that Z code documentation was correlated with greater disease burden and a higher incidence of 30-day post-operative complications following colorectal surgery.

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Cited by

Sorted by citations

Authors
Lee, J. S., MacLeod, K. E., Kuklina, E. V., Tong, X., & Jackson, S. L.
Affiliations
Centers for Disease Control and Prevention (US)
Corresponding author
Lee, Jun Soo
ORCID
Venue
AJPM Focus
Publisher
Elsevier BV
Published
2023-06
Volume
2
Issue
2
Pages
100089
ISSN
2773-0654 (ISSN-L)
DOI
10.1016/j.focus.2023.100089
PMC
PMC10546517
OpenAlex
W4322761326
Cited by
32
References
3
Citations by year
2026: 10 · 2025: 14 · 2024: 5 · 2023: 3
FWCI
7.18
Type
journal article
Language
en
Open access
Licence
Locations
  • AJPM Focus (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Centers for Disease Control and Prevention
Topics
  • Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords
social determinants of health, hypertension, Medicaid beneficiaries, health care costs, chronic disease, racial and ethnic disparities, wraparound services

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