Renwick Kelly Ann, Sanmartin Claudia, Dasgupta Kaberi, Berrang-Ford Lea, Ross Nancy
McGill University, Montréal, QC, Canada.
Appalachian State University, Boone, NC, USA.
Gerontol Geriatr Med. 2022 Nov 23;8:23337214221138442. doi: 10.1177/23337214221138442. eCollection 2022 Jan-Dec.
Hospital stays that are prolonged due to non-clinical factors are costly to health care systems and are likely suboptimal for patient well-being. We assessed the influence of psychosocial factors on hospital length of stay (LOS) for older Canadians in a retrospective cohort study. Data from the Canadian Community Health Survey were linked with the Discharge Abstract Database. Analyses were stratified by age, 55-64 ( = 1,060) and 65 and older ( = 2,718). Main predictor variables of interest included four measures of social support, sense of belonging, and living alone. Multivariate models of LOS adjusted for age, sex, income, smoking, and frailty. Among the younger respondents, low positive social interactions, low emotional/informational support, and living alone were associated with a longer LOS. Among respondents 65 and older, low affection, low positive social interactions, low emotional/informational support, and a weak sense of belonging were associated with a longer LOS. Having low social support is associated with longer hospital stays in this Canadian cohort. Social support may influence LOS as risk factors for poor health and precarious care in the community. Mitigating these risk factors could reduce the economic burden that is played out through longer hospital stays.
因非临床因素导致的住院时间延长，对医疗保健系统而言成本高昂，而且对患者福祉可能并非最佳。在一项回顾性队列研究中，我们评估了社会心理因素对加拿大老年人住院时长（LOS）的影响。来自加拿大社区健康调查的数据与出院摘要数据库相链接。分析按年龄分层，分为55 - 64岁（n = 1060）和65岁及以上（n = 2718）。主要的预测变量包括社会支持、归属感和独居情况的四项指标。住院时长的多变量模型对年龄、性别、收入、吸烟和虚弱状况进行了调整。在较年轻的受访者中，积极社交互动少、情感/信息支持低和独居与住院时间较长有关。在65岁及以上的受访者中，情感关怀少、积极社交互动少、情感/信息支持低和归属感弱与住院时间较长有关。在这个加拿大队列中，社会支持低与住院时间较长有关。社会支持可能作为社区中健康状况不佳和护理不稳定的风险因素影响住院时长。减轻这些风险因素可以减少因住院时间延长而产生的经济负担。
