Documentation of individual-level social determinants of health among adults diagnosed with cancer in the United States
Abstract The ICD-10-CM diagnosis codes ranging from Z55 to Z65 (Z codes) capture individual-level social determinants of health (SDOH) and are typically under-coded in individuals’ health records. There is limited characterization of SDOH Z codes among adults diagnosed with cancer and information ab...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2025-08-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-025-13825-3 |
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| author | Chia-Yun Hsu Gabriel Henderson Julia F. Slejko Arif Hussain Richard Scott Swain Bindu Kalesan Pei-Lin Huang Eberechukwu Onukwugha |
| author_facet | Chia-Yun Hsu Gabriel Henderson Julia F. Slejko Arif Hussain Richard Scott Swain Bindu Kalesan Pei-Lin Huang Eberechukwu Onukwugha |
| author_sort | Chia-Yun Hsu |
| collection | DOAJ |
| description | Abstract The ICD-10-CM diagnosis codes ranging from Z55 to Z65 (Z codes) capture individual-level social determinants of health (SDOH) and are typically under-coded in individuals’ health records. There is limited characterization of SDOH Z codes among adults diagnosed with cancer and information about oncologists’ perspectives on Z codes. Using pooled cross sections, we selected 35,099 adults from the IQVIA PharMetrics® Plus for Academics data and 17,852 individuals from linked cancer registry and claims data. The prevalence of comorbidities and metastatic cancer was higher among individuals with Z codes compared to those without Z code claims. The proportion of individuals with any Z code claims ranged from 0.6 to 0.9% in the PharMetrics Plus data and from 1.4 to 2.1% in the linked data. Among 112 medical oncologists/hematologists who responded to a survey about SDOH Z codes, 54% had not heard of Z codes to document SDOH. 26% reported that lack of reimbursement makes it difficult to increase their documentation and 64% would consider using Z codes if they are tied to payer reimbursement. Individuals with Z codes had greater comorbidity and cancer burden. Additional research is needed and depends on improved coding of SDOH Z codes. |
| format | Article |
| id | doaj-art-33c81df7889c4a328e45f52959d3f656 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-33c81df7889c4a328e45f52959d3f6562025-08-20T04:03:06ZengNature PortfolioScientific Reports2045-23222025-08-0115111110.1038/s41598-025-13825-3Documentation of individual-level social determinants of health among adults diagnosed with cancer in the United StatesChia-Yun Hsu0Gabriel Henderson1Julia F. Slejko2Arif Hussain3Richard Scott Swain4Bindu Kalesan5Pei-Lin Huang6Eberechukwu Onukwugha7Department of Practice, Sciences, and Health Outcomes Research, School of Pharmacy, University of MarylandDepartment of Practice, Sciences, and Health Outcomes Research, School of Pharmacy, University of MarylandDepartment of Practice, Sciences, and Health Outcomes Research, School of Pharmacy, University of MarylandProgram in Oncology, University of Maryland Greenebaum Comprehensive Cancer CenterCardinal Health Inc., & Engagement, Real-World Evidence & InsightsCardinal Health Inc., & Engagement, Real-World Evidence & InsightsDepartment of Practice, Sciences, and Health Outcomes Research, School of Pharmacy, University of MarylandDepartment of Practice, Sciences, and Health Outcomes Research, School of Pharmacy, University of MarylandAbstract The ICD-10-CM diagnosis codes ranging from Z55 to Z65 (Z codes) capture individual-level social determinants of health (SDOH) and are typically under-coded in individuals’ health records. There is limited characterization of SDOH Z codes among adults diagnosed with cancer and information about oncologists’ perspectives on Z codes. Using pooled cross sections, we selected 35,099 adults from the IQVIA PharMetrics® Plus for Academics data and 17,852 individuals from linked cancer registry and claims data. The prevalence of comorbidities and metastatic cancer was higher among individuals with Z codes compared to those without Z code claims. The proportion of individuals with any Z code claims ranged from 0.6 to 0.9% in the PharMetrics Plus data and from 1.4 to 2.1% in the linked data. Among 112 medical oncologists/hematologists who responded to a survey about SDOH Z codes, 54% had not heard of Z codes to document SDOH. 26% reported that lack of reimbursement makes it difficult to increase their documentation and 64% would consider using Z codes if they are tied to payer reimbursement. Individuals with Z codes had greater comorbidity and cancer burden. Additional research is needed and depends on improved coding of SDOH Z codes.https://doi.org/10.1038/s41598-025-13825-3Z codesSocial determinants of healthClaims dataPhysician perspectives |
| spellingShingle | Chia-Yun Hsu Gabriel Henderson Julia F. Slejko Arif Hussain Richard Scott Swain Bindu Kalesan Pei-Lin Huang Eberechukwu Onukwugha Documentation of individual-level social determinants of health among adults diagnosed with cancer in the United States Scientific Reports Z codes Social determinants of health Claims data Physician perspectives |
| title | Documentation of individual-level social determinants of health among adults diagnosed with cancer in the United States |
| title_full | Documentation of individual-level social determinants of health among adults diagnosed with cancer in the United States |
| title_fullStr | Documentation of individual-level social determinants of health among adults diagnosed with cancer in the United States |
| title_full_unstemmed | Documentation of individual-level social determinants of health among adults diagnosed with cancer in the United States |
| title_short | Documentation of individual-level social determinants of health among adults diagnosed with cancer in the United States |
| title_sort | documentation of individual level social determinants of health among adults diagnosed with cancer in the united states |
| topic | Z codes Social determinants of health Claims data Physician perspectives |
| url | https://doi.org/10.1038/s41598-025-13825-3 |
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