ASO Author Reflections: International Classification of Diseases Codes for Social Determinants of Health: Still Not Ready for Prime Time

Excerpt

There is increasing awareness and emphasis on the role of social determinants of health (SDOH) and community factors in achieving optimal surgical outcomes. However, until recently, individual level SDOH have been difficult to measure, often relying on proxy geographic measures, such as the social vulnerability index or the area deprivation index.¹ Studies utilization geographic proxies for SODH have demonstrated that surgical patients from disadvantaged communities experience higher rates of complications and mortality. Specifically, our group and others demonstrated a higher incidence of emergent operations, postoperative complications, and mortality, as well as a lower probability to achieve a textbook outcome after cancer surgery among patients from areas with less favorable SDOH.^2‐4 Recently, the International Classification of Diseases, Tenth Revision, Clinical Modification was modified to include nonbillable codes designating health hazards related to socioeconomic and psychosocial circumstances.⁵ Capturing social determinants of health by using these Z codes may help to identify more accurately patients who are at risk for worse surgical outcomes, as well as allow for targeted interventions to improve equitable surgical care. …