Perspectives of Older Adults of Low Socioeconomic Status on the Post-hospital Transition

Kangovi, Shreya; Levy, Kathryn; Barg, Frances K.; Carter, Tamala; Long, Judith A.; Grande, David

doi:10.1353/hpu.2014.0111

Cited by 20 publications

(11 citation statements)

References 38 publications

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“…In-depth interviews by Kangovi et al found that residents in high poverty areas were unable to access the care and accommodations needed to cope with post-hospital frailty. As a result, medical disability was amplified by socioeconomic disability ( 41 ).…”

Section: Discussionmentioning

confidence: 99%

Housing as a Social Determinant of Health in Singapore and Its Association with Readmission Risk and Increased Utilization of Hospital Services

Low

Wah

et al. 2016

Front. Public Health

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BackgroundResidence in public rental housing is an area-level measure of socioeconomic status, but its impact as a social determinant of health in Singapore has not been studied. We therefore aimed to examine the association of public rental housing with readmission risk and increased utilization of hospital services in Singapore.MethodsWe conducted a retrospective cohort study using retrospective 2014 data from Singapore General Hospital’s electronic health records. Variables known to affect readmission risk and health-care utilization were identified a priori and include patient demographics, comorbidities, health-care utilization in the preceding 1 year and clinical variables from the index admission in 2014. Multivariate logistic regression was used to evaluate public rental housing as an independent risk factor for admission risk, emergency department (ED), and specialist outpatient clinic attendances.ResultsA total of 14,457 unique patients were analyzed, and 2,163 patients (15.0%) were rental housing residents. Rental housing patients were significantly more likely to be male; required financial assistance; have chronic obstructive pulmonary disease; usage of anti-depressant and anti-psychotic medications; longer length of hospital stay during the index admission; and higher Charlson Comorbidity Index scores. After adjusting for demographics and clinical variables, staying in public rental housing remained an independent risk factor for readmission within 15 and 30 days, frequent hospital admissions and ED attendances in Singapore.ConclusionOur study showed an association between public rental housing with readmission risk and increased utilization of hospital services in Singapore. A deeper understanding of the residents’ social circumstances and health seeking behavior would be insightful.

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Section: Discussionmentioning

confidence: 99%

Housing as a Social Determinant of Health in Singapore and Its Association with Readmission Risk and Increased Utilization of Hospital Services

Low

Wah

et al. 2016

Front. Public Health

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“… 3 , 16 They also include patients who face inequities in access to care and quality of healthcare created by social disparities including poverty, limited health literacy, low education or belonging to an ethnic or racial minority. 2 , 3 , 6 - 8 , 17 , 18 Since the 2006 IOM report, some important advances have been made to reduce inequities and improve care transitions for sub-groups of at-risk cancer patients who face social disparities, including the advent of patient navigation programs. 19 Yet there has been little exploration of using interdisciplinary primary care-led transition clinics to achieve these goals despite growing evidence of their merit in non-cancer, primary care-based research.…”

Section: Transitions In Cancer Carementioning

confidence: 99%

Primary Care-Led Transition Clinics Hold Promise in Improving Care Transitions for Cancer Patients Facing Social Disparities: A Commentary

Malebranche

Sarivalasis²,

Peters³

et al. 2020

J Prim Care Community Health

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Transitions in care are key junctions during which care coordination, communication, and individualized support are required to ensure optimal health outcomes for patients. This is particularly true for patients who face social disparities, such as poverty, limited health literacy, or belonging to a racial or ethnic minority, who are particularly at risk for experiencing poor care transitions. Interdisciplinary primary care-led transition clinics are an intervention that have shown promise in improving care transitions for diverse patient populations, including those that face social disparities, but their role in improving transitions in cancer care remains largely untapped. In this commentary we highlight why the time-limited support of an interdisciplinary primary care-led transition clinic that targets socially vulnerable cancer patients holds the promise of achieving more equitable healthcare access, healthcare quality, and ultimately more equitable health outcomes for cancer patients.

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“…Essential elements of good quality health care for older people who need support to live at home have been proposed in other qualitative studies. These elements of good quality care have included the following: health providers being knowledgeable and skilled in geriatric care ; holistic and person‐centred approaches and effective communication skills . Several studies have reported challenges for care workers in promoting the self‐determination of older people in home‐based care decisions .…”

Section: Introductionmentioning

confidence: 99%

“…The persistent nature of reported issues such as unmet needs , limited responsiveness of care and poor communication skills suggests that gaps exist in knowledge about how to address well‐known problems. In response to these gaps, our study was conducted to explore the quality of health care for older people who need support to live at home, from the perceptions of older people, carers and key informants.…”

Section: Introductionmentioning

confidence: 99%

Visibility and meanings of partnership in health care for older people who need support to live at home

Gregory

Mackintosh

Kumar

et al. 2017

Scandinavian Caring Sciences

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We concluded that older people who need support to live at home are not highly visible to health providers, policymakers and researchers as a central partner and consumer to be meaningfully engaged in shaping their health care. Opportunities to address persistent issues with quality of health care may in future be achieved through stronger partnerships between older people and health providers, to find new ways to improve the quality of care for older people.

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Perspectives of Older Adults of Low Socioeconomic Status on the Post-hospital Transition

Abstract: Strategies that address socioeconomic stressors of hospitalization and provide empathic support may improve the post-hospital transition for these high-risk individuals.

Cited by 20 publications

References 38 publications

Housing as a Social Determinant of Health in Singapore and Its Association with Readmission Risk and Increased Utilization of Hospital Services

Housing as a Social Determinant of Health in Singapore and Its Association with Readmission Risk and Increased Utilization of Hospital Services

Primary Care-Led Transition Clinics Hold Promise in Improving Care Transitions for Cancer Patients Facing Social Disparities: A Commentary

Visibility and meanings of partnership in health care for older people who need support to live at home

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