Social network predictors of outcomes for the hospitalized elderly

This study sought to determine if particular structural characteristics and support functions of the social networks of older hospitalized patients were associated with how they did while in the hospital and during the period following discharge. Through a longitudinal study design, data were collected on a range of variables upon admission to the hospital, at discharge, and after discharge. A logistic regression analysis model was used to determine if social network, personal, and severity of illness patient characteristics were predictive of selected outcomes (rehospitalization, a morbid event, home care after discharge, and loneliness at follow-up). It was hypothesized that patients with small networks; without a spouse; with fewer relatives and friends they felt close to and saw frequently; who were not members of religious organizations and other groups; and who received less instrumental and emotional support from their networks would have poorer outcomes. There was limited support for the hypotheses. Patients with smaller networks and less instrumental support had more morbid events, without a spouse were lonelier, and with fewer memberships received more home care. Also, those patients receiving Medicaid, with longer lengths of stay, and on the geriatrics service experienced poorer outcomes on certain indicators. The findings underscore the complexity of factors impacting on the outcomes of sick older people and the somewhat limited role of social networks relative to considerations such as health status, income, and the availability of formal care services. In addition, as people become older and frailer, such as in this group with an average age of 79 years, the formal medical system becomes more important. The findings suggest that social workers attempt to ensure continuity of care after discharge through efforts to bridge the informal and formal care sectors, keeping in mind that the balance of responsibility has often shifted to the formal system despite relatively large and interactive social networks among older people