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Using Z Codes to Document Social Risk Factors in the Electronic Health Record

A Scoping Review

Datos Bibliográficos

ID9104867
AutoresKelley M Baker (0000-0002-2473-9606, George Mason University, autor de correspondencia), Mary A Hill (0000-0003-0352-2237, Toronto East General Hospital), Debora Goetz Goldberg (0000-0003-3121-7942, George Mason University, autor de correspondencia), Panagiota Kitsantas (0000-0003-0261-9002, George Mason University, autor de correspondencia), Kristen Miller (0009-0006-1984-8310, MedStar Health), Kristen E Miller (MedStar Health Research Institute), Kelly M Smith (0000-0002-9483-5118, Toronto East General Hospital), Alicia Hong (George Mason University, autor de correspondencia)
Año2025
Volumen63
Número3
Páginas211-221
Fecha de publicación2025-03-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000002101
PMID39570573
OpenAlexW4404573003
IdiomaEN
Citas recibidas1
Referencias citadas52

INTRODUCTION: Individual-level social risk factors have a significant impact on health. Social risks can be documented in the electronic health record using ICD-10 diagnosis codes (the "Z codes"). This study aims to summarize the literature on using Z codes to document social risks. METHODS: A scoping review was conducted using the PubMed, Medline, CINAHL, and Web of Science databases for papers published before June 2024. Studies were included if they were published in English in peer-reviewed journals and reported a Z code utilization rate with data from the United States. RESULTS: Thirty-two articles were included in the review. In studies based on patient-level data, patient counts ranged from 558 patients to 204 million, and the Z code utilization rate ranged from 0.4% to 17.6%, with a median of 1.2%. In studies that examined encounter-level data, sample sizes ranged from 19,000 to 2.1 billion encounters, and the Z code utilization rate ranged from 0.1% to 3.7%, with a median of 1.4%. The most reported Z codes were Z59 (housing and economic circumstances), Z63 (primary support group), and Z62 (upbringing). Patients with Z codes were more likely to be younger, male, non-White, seeking care in an urban teaching facility, and have higher health care costs and utilizations. DISCUSSION: The use of Z codes to document social risks is low. However, the research interest in Z codes is growing, and a better understanding of Z code use is beneficial for developing strategies to increase social risk documentation, with the goal of improving health outcomes

CINAHL · Diagnosis code · Environmental health · Family medicine · Health care · MEDLINE · Political science · Population · Psychological intervention · Chronic Disease Management Strategies · Food Security and Health in Diverse Populations · Medical Coding and Health Information · Medicine · Nursing · Psychology

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    Open Access•Paula Chatterjee, Eliza Macneal et al.•JAMA Health Forum•2025

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Obras citantes distintas1
Citas por año1
Intervalo de citas2025 - 2025 (1)
Velocidad de citaciónrecent
Altamente citadoNo
Tipos de citaNeutras: 1
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