title: Social Determinants of Discharge Outcomes in Older People Admitted to a Geriatric Medicine Ward.
abstract: The factors determining hospital discharge outcomes in older people are complex. This retrospective study was carried out in an in-patient geriatric ward over a month in 2015 and aimed to explore if self-reported feeling of loneliness and clinical frailty contribute to longer hospital stays or higher rates of readmission to hospital after discharge in the older population. Twenty-two men and twenty-five women (mean age 85.1 years) were assessed. There was a significant multivariate association between both self-reported loneliness (p=0.021) and the Clinical Frailty Scale (p=0.010) with length of stay, after adjusting for age, dementia and living alone. In multivariate analysis, patients who lived alone were more likely to be readmitted to hospital within 30 days (p=0.036). Loneliness, living alone and clinical frailty were associated with adverse discharge outcomes. Lower thresholds for referral to voluntary organisations and for psychosocial interventions in patients who report loneliness or live alone may be beneficial.
authors.affiliation: Martha Hawker, University of Cambridge, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom, Mh666@cam.ac.uk.
authors.forename: M
authors.initials: M
authors.lastname: Hawker
authors.forename: R
authors.initials: R
authors.lastname: Romero-Ortuno
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly / Q000523:psychology / Q000706:statistics & numerical data; D015577:Geriatric Assessment / Q000379:methods; D005853:Geriatrics / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008132:Loneliness; D008297:Male; D020380:Needs Assessment; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012944:Social Support; D006113:United Kingdom / Q000453:epidemiology