Is social capital protective against hospital readmissions?

Hanna Zlotnick,Kenneth M Langa,Tedi A Engler,Geoffrey J Hoffman,Andrew M Ryan,Ushapoorna Nuliyalu

doi:10.1186/s12913-020-05092-x

Abstract

BackgroundTo evaluate the association between social capital and 30-day readmission to the hospital among Medicare beneficiaries overall, beneficiaries with dementia and related memory disorders, and beneficiaries with dual eligibility for Medicaid.MethodsUsing Health and Retirement Study (HRS) data linked with 2008–2015 Medicare claims from traditional Medicare beneficiaries hospitalized during the study period (1246 unique respondents, 2212 total responses), we examined whether dementia and related memory disorders and dual eligibility were associated with social capital. We then estimated a multiple regression model to test whether social capital was associated with a reduced likelihood of readmission.ResultsDementia was associated with an − 0.241 standard deviation (sd) change in social capital (95% CI: − 0.378, − 0.103), dual eligibility with a − 0.461 sd change (95% CI: − 0.611, − 0.310), and the occurrence of both was associated with an additional − 0.236 sd change (95% CI: − 0.525, − 0.053). 30-day readmission rates were 14.47% over the study period. In both adjusted and unadjusted models, social capital was associated with small and nonsignificant differences in 30-day readmissions. These effects did not vary across dementia status and socioeconomic status.ConclusionsDementia and dual eligibility were associated with lower social capital, but social capital was not associated with the risk of readmission for any population.

Highlights

To evaluate the association between social capital and 30-day readmission to the hospital among Medicare beneficiaries overall, beneficiaries with dementia and related memory disorders, and beneficiaries with dual eligibility for Medicaid
Whether certain social capital factors may be protective against readmission, patients with dementia and related memory disorders or of low socioeconomic status, is unknown
Among patients of low socioeconomic status, social capital could serve a protective role against readmission because of its capacity to provide meaningful connections and support after discharge that aid in patient-physician communication, the ability to get to appointments, and have a support network to assist with recovery

Summary

Introduction

To evaluate the association between social capital and 30-day readmission to the hospital among Medicare beneficiaries overall, beneficiaries with dementia and related memory disorders, and beneficiaries with dual eligibility for Medicaid. Hospitals that care for patients with lower income and education, and higher rates of disability, have been more likely to be penalized, and at greater financial cost, under the program [1, 2] These penalties have been challenged as unfair, arising from their patients’ greater social and clinical. Whether certain social capital factors may be protective against readmission, patients with dementia and related memory disorders or of low socioeconomic status, is unknown. Social capital may enhance decision-making, communication, planning, and care networks All of these factors play significant roles in physician-patient interactions, recovery, and readmission [5,6,7,8,9]. Among patients of low socioeconomic status, social capital could serve a protective role against readmission because of its capacity to provide meaningful connections and support after discharge that aid in patient-physician communication, the ability to get to appointments, and have a support network to assist with recovery

Objectives

Methods

Results

Conclusion