Documentation of individual-level social determinants of health among adults diagnosed with cancer in the United States

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 oncol...

Full description

Saved in:
Bibliographic Details
Published in:Scientific reports Vol. 15; no. 1; pp. 29646 - 11
Main Authors: Hsu, Chia-Yun, Henderson, Gabriel, Slejko, Julia F., Hussain, Arif, Swain, Richard Scott, Kalesan, Bindu, Huang, Pei-Lin, Onukwugha, Eberechukwu
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 13.08.2025
Nature Publishing Group
Nature Portfolio
Subjects:
692/4028/67
692/4028/67/2324
692/499
Adult
Aged
Beneficiaries
Cancer
Claims data
Codes
Comorbidity
Cross-Sectional Studies
Documentation
Electronic health records
Female
Health care expenditures
Humanities and Social Sciences
Humans
International Classification of Diseases
Male
Mammography
Medicaid
Medicare
Metastases
Metastasis
Middle Aged
multidisciplinary
Neoplasms - diagnosis
Neoplasms - epidemiology
Oncology
Patients
Physician perspectives
Registries
Science
Science (multidisciplinary)
Social determinants of health
Social Determinants of Health - statistics & numerical data
Socioeconomic factors
United States - epidemiology
Z codes
United States
United States > US
Social determinants of health
Z codes
Claims data
Physician perspectives
ISSN:2045-2322, 2045-2322
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 14
content type line 23
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-025-13825-3