Critically ill children have social needs. Inpatient social workers (SW) address needs through social resource provision (SRP). We aimed to describe the characteristics of patients receiving SRP during PICU hospitalization and study associations between SRP and 6-month hospital rehospitalizations and healthcare costs.
Retrospective single center cohort study of all PICU encounters 1/1/2023-12/31/2023. SW engagement (SWE) and SRP were identified and categorized through chart review. Encounters with SWE and SRP were described with summary statistics and a Cox proportional hazards model was trained on rehospitalization.
1,130 of 1507 (75%) PICU hospitalizations met with PICU SW and 459 (30.5%) received SR. Children with SRP were younger (2 vs. 5 years, p < 0.001), had more complex chronic diseases (65.6% vs. 52.3%, p < 0.001), lower zip-code median household income ($53,316 vs. $55,337 p = 0.001), and childhood opportunity index (very low 32.5% vs. 24.2%, p = 0.006). These children had longer PICU LOS (2 vs. 1 day, p < 0.001) and higher PELOD-2 scores (10 vs. 1, p < 0.001), mortality (5.4% vs. 1.6%, p < 0.001), and cost ($36,935 vs. $15,656, p < 0.001). 1,348 encounters were included in rehospitalization modeling. After adjustment, social resource provision was associated with an adjusted rehospitalization hazard of 0.77 (95% CI 0.62, 0.96), with an estimated cost avoidance of $835 (95% CI: $128, $1,569) per encounter.
Critically ill children are at risk for social needs. SRP during PICU hospitalization may reduce rehospitalization rates and healthcare costs.
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