Social influences on length of hospitalization in a major academic medical center

Abstract

Social science research suggests that personal interactions can trigger changes in emotional state, behavior, attitudes, or opinions, and that these changes can have clinically significant outcomes for users of the health care system.Hospital room assignment, a largely random process, may create new social relationships that influence individual social states. The nature of these social relationships can impact clinical outcomes as social interactions. The placement, presence, or circumstance of social relations, and perhaps even the presence of another individual are key components of the care process. This study tests the idea that peer and social support effects may influence measurable clinical outcomes among hospitalized patients.A large, retrospective dataset extracted from the clinical record of a major academic medical center was used to explore the impact of chance socially and clinically concordant matches on a patient's length of stay in the hospital, employing a variant of the standard lagged linear-in-means peer influence model, where markers for clinical outcomes of the focus patient at time of discharge from the hospital are regressed on the concordance of peer group-average of markers for sociodemographic factors and clinical condition of the roommates with related factors and conditions of the focus patient, controlling for nosocomial conditions and relevant characteristics of the focus patient.I find that evidence that social concordance influences patient length of stay, supporting the hypothesis that decreased social distance between hospitalized roommates may be clinically beneficial due to shorter hospital stays, and that these benefits may be mediated by information sharing, psychological comfort due to affiliation with a similar other, or by sharing clinically similar experiences.