Primary care patients living with social challenges receive a lower quality of health care, leading to poorer health outcomes, find researchers in Manitoba, Canada. Among the 600,000 patients who were examined, the researchers identified that half live with social challenges, such as low income, mental health diagnosis, and involvement with the justice system.
Fifty-four percent of patients had at least one social complexity, and four percent had more five or more. Social complexity was strongly associated with poorer outcomes on primary care indicators for prevention, e.g., breast cancer screening (OR 0.77, 99% CI); managing chronic disease, e.g., diabetes (OR 0.86, 99% CI); care of older adults, e.g., benzodiazepine prescriptions (OR 1.63, 99% CI); and use of health services, e.g., ambulatory visits (OR 1.09, 99% CI).
Patients with more social complexities were less likely to receive preventive services and more likely to seek ambulatory or emergency care. To achieve better health equity for vulnerable patient populations, the authors recommend expanding interdisciplinary team-based care tailored to individual practices' patient populations and exploring alternative funding models that acknowledge the complexity of addressing social determinants of health in the primary care setting.