Examining the Association Between Social Needs and Care Gap Closure Among Older Adults Receiving Dental Care

Introduction We sought to 1) describe the prevalence of social needs and 2) determine whether social needs were associated with closure of care gaps among patients aged 65 and older seeking dental care. Methods In this retrospective cross-sectional study, we identified 754 Kaiser Permanente Northwest (KPNW) patients aged 65+ years who completed an index dental visit, had at least one of 23 preventive care gaps (e.g. flu vaccination) or disease management care gaps (e.g. diabetes HbA1c screening test) documented in their medical record, and had completed a social needs assessment via survey evaluating financial strain, food insecurity, housing needs, social isolation, and transportation needs. We described the prevalence of social needs at the index visit, then used logistic regression to evaluate the association between the number of social needs (0, 1, 2+) and closure of all care gaps over the following 60 days (yes vs. no), adjusting for patient characteristics. Identification and closure of care gap was assessed via KPNW's Panel Support Tool. Results Approximately 28% of patients reported ≥1 social needs. The prevalence of social needs was as follows: social isolation: 13.7%; financial strain: 11.3%; food insecurity: 7.7%; transportation needs: 5.4%; and housing needs: 3.3%. Those with 1 social need were more likely to close care gaps than those with no social needs (OR=1.82, 95% CI=1.17-2.85). No significant association was found with care gap closure among those with 2+ versus zero social needs. Conclusion The prevalence of social needs was nearly 30% among patients aged 65 and over with dental and medical coverage. Patients with one social need were more likely than those with no social needs to close all care gaps following their visit.