ArticleJournal of the American Medical Directors Association2023
Social Risk Factors are Associated with Risk for Hospitalization in Home Health Care: A Natural Language Processing Study.
Article in Journal of the American Medical Directors Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Applications of Natural Language Processing and Large Language Models for Social Determinants of Health: Systematic Review.Journal of medical Internet research · 2026Pooled it
- Food insecurity and acute care utilisation: a systematic review and meta-analysis.BMJ public health · 2026Article
- Adverse Social Determinants of Health and Urinary Incontinence Among Older Adult Women in Home Health Care.Journal of the American Medical Directors Association · 2025Article
- Nonlinear Relationship Between Vital Signs and Hospitalization/Emergency Department Visits Among Older Home Healthcare Patients and Critical Vital Sign Cutoff for Adverse Outcomes: Application of Generalized Additive Model.Clinical nursing research · 2025Article
- Development and validation of competencies for home-based nursing care: an e-Delphi study.International journal of nursing studies advances · 2025Article
- Documentation of social determinants of health across individuals from different racial and ethnic groups in home healthcare.Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing · 2025Article
- Social Determinants Documented Across Individuals from Different Racial and Ethnic Groups in Home Healthcare.Studies in health technology and informatics · 2024Article
- Topic modeling on clinical social work notes for exploring social determinants of health factors.JAMIA open · 2024Article
- Natural Language Processing Applied to Clinical Documentation in Post-acute Care Settings: A Scoping Review.Journal of the American Medical Directors Association · 2024Article
- Article
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
Abstract
objectiveThis study aimed to develop a natural language processing (NLP) system that identified social risk factors in home health care (HHC) clinical notes and to examine the association between social risk factors and hospitalization or an emergency department (ED) visit.
designRetrospective cohort study. SETTING AND
participantsWe used standardized assessments and clinical notes from one HHC agency located in the northeastern United States. This included 86,866 episodes of care for 65,593 unique patients. Patients received HHC services between 2015 and 2017.
methodsGuided by HHC experts, we created a vocabulary of social risk factors that influence hospitalization or ED visit risk in the HHC setting. We then developed an NLP system to automatically identify social risk factors documented in clinical notes. We used an adjusted logistic regression model to examine the association between the NLP-based social risk factors and hospitalization or an ED visit.
resultsOn the basis of expert consensus, the following social risk factors emerged: Social Environment, Physical Environment, Education and Literacy, Food Insecurity, Access to Care, and Housing and Economic Circumstances. Our NLP system performed "very good" with an F score of 0.91. Approximately 4% of clinical notes (33% episodes of care) documented a social risk factor. The most frequently documented social risk factors were Physical Environment and Social Environment. Except for Housing and Economic Circumstances, all NLP-based social risk factors were associated with higher odds of hospitalization and ED visits. CONCLUSIONS AND IMPLICATIONS: HHC clinicians assess and document social risk factors associated with hospitalizations and ED visits in their clinical notes. Future studies can explore the social risk factors documented in HHC to improve communication across the health care system and to predict patients at risk for being hospitalized or visiting the ED.
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Registered trials
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