title: Social isolation predicts re-hospitalization in a group of older American veterans enrolled in the UPBEAT Program. Unified Psychogeriatric Biopsychosocial Evaluation and Treatment.
abstract: OBJECTIVE
  Does social isolation predict re-hospitalization in a group of older men enrolled in Unified Psychogeriatric Biopsychosocial Evaluation and Treatment (UPBEAT), a mental health care-coordination project at nine Veterans Affairs Healthcare Centers nationwide?
  
  
  METHODS
  The current study examined 123 UPBEAT patients located at West Los Angeles, whose ratings were available on the Lubben Social Network Scale (LSNS), the SF-36 scale, the Cumulative Illness Rating Scale (CIRS) and the Mental Health Index (MHI-38) Depression and Anxiety subscales. Within one year of enrollment, 55% of patients were re-hospitalized. Odds of re-hospitalization were calculated using two logistic regression models. Social isolation risk (LSNS) and demographic covariates were included. In addition, Model 1 contained depression and anxiety measures (MHI-38) and physician-rated medical burden (CIRS), while in Model 2, patient-perceived physical (PCS) and mental health (MCS) subscales from the SF-36 were included.
  
  
  RESULTS
  The group of patients who were socially isolated or at high or moderate risk for isolation, were 4-5 times more likely to be re-hospitalized within the year, than low isolation risk patients. In both Models 1 (chi-square = 19.86; p = 0.031) and 2 (chi-square = 26.42; p = 0.002) demographic characteristics were not significant predictors of re-hospitalization, but social isolation risk was a significant predictor (Model 1: odds ratio (OR) = 5.31; 95% confidence intervals (CI) = 1.81-15.53; and Model 2: OR = 3.86; 95% CI = 1.39-10.73). In addition, MHI-Anxiety was a significant predictor (OR = 1.22; 95% CI = 1.05-1.43) in Model 1 and in Model 2, patient-perceived physical health significantly predicted re-hospitalization (OR = 0.91; 95% CI = 0.86-0.96).
  
  
  CONCLUSIONS
  When controlling for other covariates, social isolation, physical health and mental health were significant risk factors for re-hospitalization. These findings underline the importance of assessing and addressing lack of social support, along with other factors, in the health care of older male veterans.
authors.affiliation: VA Greater Los Angeles Healthcare System-West LA Healthcare Center, 116S, Los Angeles, California 90073, USA. riteshm@ucla.edu
authors.forename: R
authors.initials: R
authors.lastname: Mistry
authors.forename: J
authors.initials: J
authors.lastname: Rosansky
authors.forename: J
authors.initials: J
authors.lastname: McGuire
authors.forename: C
authors.initials: C
authors.lastname: McDermott
authors.forename: L
authors.initials: L
authors.lastname: Jarvik
mesh_terms: D000368:Aged; D005544:Forecasting; D006299:Health Services for the Aged / Q000458:organization & administration* / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010359:Patient Readmission; D011379:Prognosis; D012307:Risk Factors; D012934:Social Isolation / Q000523:psychology*; D012944:Social Support; D014728:Veterans / Q000523:psychology*