Exploring and characterising usage of social determinants of health codes in General Practices in England using CPRD

Background Social determinants of health (SDOH) critically influence population and individual health outcomes. General Practice is often the first point of contact for people with social issues, however it is unclear whether or how GPs record this information. Aims and objectives This study aims to evaluate SDOH coding practices in primary care, identify patterns, estimate unmet social needs, and analyse impact on health outcomes. Specific objectives: 1. Evaluate variations in SDOH code usage by demographics (age, sex, ethnicity), geographical regions, and consultation types 2. Compare rates of code usage to nationally available data to estimate coding completeness 3. Gather initial estimates of unmet social need, associations with key health and care outcomes and referral rates to social prescribing link workers Methods CPRD Aurum will be used to identify SDOH codes in patients aged 18 years and over between 2004-2024. A SDOH code list will be generated from the study which will be publicly available for use by NHSE, ICBs, researchers and clinicians. We will examine frequency of SDOH code usage, describe characteristics of those with a documented SDOH code (exposed cohort) and analyse associations with healthcare utilisation (e.g. consultation rates, mortality, fit-notes) using multinomial logistic regression models and estimate absolute risk differences. Anticipated impact and dissemination • Findings will lead to a peer reviewed publication and presentation at a key primary care or public health conference. Results will be disseminated to participants, local communities and the public through a lay summary in different languages. • Publication of SDOH code list