Social Vulnerability and Frailty in Hospitalized Older Adults

Area of Science:

• Geriatric Medicine
• Public Health
• Health Services Research

Background:

• Social vulnerability, defined as accumulated social disadvantages, is linked to poor health outcomes.
• Previous research on social vulnerability has largely excluded frail hospitalized individuals.
• This study investigates the impact of social vulnerability on hospital outcomes in older adults.

Purpose of the Study:

• To examine how social vulnerability affects hospital outcomes and resource utilization in elderly patients.
• To assess the association between social vulnerability and length of stay, extended LOS, ALC, mortality, and discharge to LTC.

Main Methods:

• Analysis of 1,146 patients aged 65+ admitted via Emergency Department from 2009-2020.
• Calculation of a 20-item social vulnerability index (SVI) and a 57-item frailty index (FI) using deficit accumulation.
• Outcomes measured included length of stay (LOS), extended LOS, alternative level of care (ALC), in-hospital mortality, and discharge to long-term care (LTC).

Main Results:

• Increased social vulnerability index (SVI) scores correlated with longer hospital length of stay (LOS) (1.15 days per 0.1 SVI unit increase).
• Social vulnerability was associated with extended LOS (aOR 1.19) and alternative level of care (ALC) status (aOR 1.39).
• Social vulnerability was linked to discharge to long-term care (LTC) (aOR 1.03), but not in-hospital mortality.

Conclusions:

• Social vulnerability independently predicts prolonged hospitalization, ALC designation, and discharge to LTC among older adults.
• Findings underscore the need to consider social vulnerability in hospital care planning and resource allocation.
• Screening for social vulnerability can inform interventions to mitigate adverse hospital outcomes and long-term care needs.