Unmet social needs and no-show visits in primary care in a US Northeastern urban health system, 2018–2019

Kevin P. Fiori, Caroline G. Heller, Colin D. Rehm, Amanda Parsons, Anna Flattau, Sandra Braganza, Kelly Lue, Molly Lauria, Andrew Racine

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Objectives. To characterize the association between social needs prevalence and no-show proportion and variation in these associations among specific social needs. Methods. In this study, we used results from a 10-item social needs screener conducted across 19 primary care practices in a large urban health system in Bronx County, New York, between April 2018 and July 2019. We estimated the association between unmet needs and 2-year history of missed appointments from 41 637 patients by using negative binomial regression models. Results. The overall no-show appointment proportion was 26.6%. Adjusted models suggest that patients with 1 or more social needs had a significantly higher no-show proportion (31.5%) than those without any social needs (26.3%), representing an 19.8% increase (P < .001). We observed a positive trend (P < .001) between the number of reported social needs and the no-show proportion—26.3% for those with no needs, 30.0% for 1 need, 32.1% for 2 needs, and 33.8% for 3 or more needs. The strongest association was for those with health care transportation need as compared with those without (36.0% vs 26.9%). Conclusions. We found unmet social needs to have a significant association with missed primary care appointments with potential implications on cost, quality, and access for health systems.

Original languageEnglish (US)
Pages (from-to)S242-S250
JournalAmerican journal of public health
StatePublished - Jul 2020

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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