What is it about?
In old age people may become more socially isolated, and prior studies have shown that isolated people have worse health and may die sooner. Social isolation can be viewed and measured in two different ways: 1) objectively, counting the number of friends and family an individual interacts with regularly, and how frequently they meet-up with people in their social circle, and 2) subjectively, with questions asking if people feel "lonely", using questions that get at a sense of belonging or feeling of disconnectedness. This study tries to figure out if more health care is used by older adults who are socially isolated, by looking for differences in how much Medicare spends for lonely seniors, and differences in what it spends for those who are objectively isolated and those who are not. The results show that feeling lonely doesn't seem to go along with increased health care, but that being objectively isolated--meaning, having less interaction and support with family or friends--leads to Medicare spending more on healthcare. In particular, comparing older adults who have similar health problems, Medicare ends up spending more for hospital and nursing-home care when the patient is socially isolated. The socially isolated patients are also at higher risk of dying.
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Why is it important?
This is the first work to demonstrate that the health risks of social isolation translates to increased spending for Medicare. It suggests there is potential for programs aimed at improving social support could not only benefit older patients but might also save money.
Perspectives
As a family physician i regularly see the difference it makes when elderly patients have strong family support--often demonstrated by presence of a family member at our visits--compared to other patients who are struggling with chronic health problems on their own and only have me, my staff, and the healthcare system to turn to. The findings of this study reinforce the importance of social determinants and social barriers to good health, and that finding the "right treatment" is more than prescribing a therapy, but requires insurers and providers to acknowledge the important role of interventions to address social needs. This study is evidence that working to address social isolation in older adults in the community is not only the compassionate course, but also makes sense from a public health and financial perspective.
Jonathan Shaw
Stanford University
Read the Original
This page is a summary of: Social Isolation and Medicare Spending: Among Older Adults, Objective Isolation Increases Expenditures While Loneliness Does Not, Journal of Aging and Health, September 2017, SAGE Publications,
DOI: 10.1177/0898264317703559.
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