Resident loneliness, social isolation and unplanned emergency department visits from supportive living facilities: a population-based study in Alberta, Canada

BMC Geriatrics

Zoe Hsu¹  Erik Youngson¹  Stephanie A. Chamberlain²  Andrea Gruneir³  Susan E. Bronskill⁴ 

[1] Data and Research Services, Alberta SPOR Support Unit and Provincial Research Data Services, Alberta Health Services, Edmonton, Alberta, Canada;Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, 6-50 University Terrace, T6G 2T4, Edmonton, Alberta, Canada;Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, 6-50 University Terrace, T6G 2T4, Edmonton, Alberta, Canada;ICES, Toronto, Ontario, Canada;Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada;ICES, Toronto, Ontario, Canada;Management & Evaluation, Dalla Lana School of Public Health, Institute of Health Policy, University of Toronto, Toronto, Ontario, Canada;Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada;Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada;

关键词: Supportive living;    Emergency department visits;    Loneliness;    Social isolation;   

DOI  :  10.1186/s12877-021-02718-5

来源: Springer

【 摘 要 】

BackgroundSupportive living (SL) facilities are intended to provide a residential care setting in a less restrictive and more cost-effective way than nursing homes (NH). SL residents with poor social relationships may be at risk for increased health service use. We describe the demographic and health service use patterns of lonely and socially isolated SL residents and to quantify associations between loneliness and social isolation on unplanned emergency department (ED) visits.MethodsWe conducted a retrospective cohort study using population-based linked health administrative data from Alberta, Canada. All SL residents aged 18 to 105 years who had at least one Resident Assessment Instrument-Home Care (RAI-HC) assessment between April 1, 2013 and March 31, 2018 were observed. Loneliness and social isolation were measured as a resident indicating that he/she feels lonely and if the resident had neither a primary nor secondary caregiver, respectively. Health service use in the 1 year following assessment included unplanned ED visits, hospital admissions, admission to higher levels of SL, admission to NH and death. Multivariable Cox proportional hazard models examined the association between loneliness and social isolation on the time to first unplanned ED visit.ResultsWe identified 18,191 individuals living in Alberta SL facilities. The prevalence of loneliness was 18% (n = 3238), social isolation was 4% (n = 713). Lonely residents had the greatest overall health service use. Risk of unplanned ED visit increased with loneliness (aHR = 1.10, 95% CI: 1.04–1.15) but did not increase with social isolation (aHR = 0.95, 95% CI: 0.84–1.06).ConclusionsLonely residents had a different demographic profile (older, female, cognitively impaired) from socially isolated residents and were more likely to experience an unplanned ED visit. Our findings suggest the need to develop interventions to assist SL care providers with how to identify and address social factors to reduce risk of unplanned ED visits.

【 授权许可】

CC BY