Association of the Social Determinants of Health With Quality of Primary Care

Annals of Family Medicine
Alan KatzScott McCulloch

Abstract

In primary care, there is increasing recognition of the difficulty of treating patients' immediate health concerns when their overall well-being is shaped by underlying social determinants of health. We assessed the association of social complexity factors with the quality of care patients received in primary care settings. Eleven social complexity factors were defined using administrative data on poverty, mental health, newcomer status, and justice system involvement from the Manitoba Population Research Data Repository. We measured the distribution of these factors among primary care patients who made at least 3 visits during 2010-2013 to clinicians in Manitoba, Canada. Using generalized linear mixed modeling, we measured 26 primary care indicators to compare the quality of care received by patients with 0 to 5 or more social complexity factors. Among 626,264 primary care patients, 54% were living with at least 1 social complexity factor, and 4% were living with 5 or more. Social complexity factors were strongly associated with poorer outcomes with respect to primary care indicators for prevention (eg, breast cancer screening; odds ratio [OR] = 0.77; 99% CI, 0.73-0.81), chronic disease management (eg, diabetes management; OR ...Continue Reading

Citations

Jan 3, 2019·Annual Review of Public Health·Debra Haire-Joshu, Felicia Hill-Briggs
Mar 29, 2019·Journal of Burn Care & Research : Official Publication of the American Burn Association·Adam PadalkoSarvesh Logsetty
May 1, 2020·Journal of Burn Care & Research : Official Publication of the American Burn Association·Adam PadalkoSarvesh Logsetty
Sep 3, 2020·Population Health Management·Matthew W KreuterAlina A Luke
Aug 30, 2019·JAMA : the Journal of the American Medical Association·Karina W Davidson, Thomas McGinn
Nov 5, 2020·Epidemiologia E Serviços De Saúde : Revista Do Sistema Unico De Saúde Do Brasil·Jessye Melgarejo do Amaral GiordaniJuliana Balbinot Hilgert
Dec 17, 2020·Annual Review of Public Health·Matthew W KreuterRachel Garg
Jul 11, 2021·Family Medicine and Community Health·Jennifer A LucasJohn Heintzman
Mar 23, 2020·American Journal of Preventive Medicine·Caroline G HellerColin D Rehm

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