Social Isolation and Medicare Spending: Among Older Adults, Objective Social Isolation Increases Expenditures while Loneliness Does Not
Evaluate objective isolation and loneliness' impact on Medicare spending and outcomes. We linked Health and Retirement Study data to Medicare claims to analyze objective isolation (scaled composite of social contacts and network) and loneliness (positive response to 3-item loneliness scale) as...
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| Veröffentlicht in: | Journal of aging and health 2017-10, Vol.29 (7), p.1119-1143 |
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| container_title | Journal of aging and health |
| container_volume | 29 |
| creator | Shaw, Jonathan G Farid, Monica Noel-Miller, Claire Joseph, Neesha Houser, Ari Asch, Steven M Bhattacharya, Jay Flowers, Lynda |
| description | Evaluate objective isolation and loneliness' impact on Medicare spending and outcomes.
We linked Health and Retirement Study data to Medicare claims to analyze objective isolation (scaled composite of social contacts and network) and loneliness (positive response to 3-item loneliness scale) as predictors of subsequent Medicare spending. In multivariable regression adjusting for health and demographics, we determined marginal differences in Medicare expenditures. Secondary outcomes included spending by setting, and mortality.
Objective isolation predicts greater spending, $1,644(p |
| doi_str_mv | 10.1177/0898264317703559 |
| format | Article |
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We linked Health and Retirement Study data to Medicare claims to analyze objective isolation (scaled composite of social contacts and network) and loneliness (positive response to 3-item loneliness scale) as predictors of subsequent Medicare spending. In multivariable regression adjusting for health and demographics, we determined marginal differences in Medicare expenditures. Secondary outcomes included spending by setting, and mortality.
Objective isolation predicts greater spending, $1,644(p<0.001) per beneficiary annually, whereas loneliness predicts reduced spending, -$768(p<0.001). Increased spending concentrated in inpatient and nursing-home (SNF) care; despite more healthcare, objectively isolated beneficiaries had 31%(p<0.001) greater risk of death. Loneliness did not predict SNF use nor mortality, but predicted slightly less inpatient and outpatient care.
Objectively isolated seniors have higher Medicare spending, driven by increased hospitalization and institutionalization, and face greater mortality. Policies supporting social connectedness could reap significant savings.</description><identifier>ISSN: 0898-2643</identifier><identifier>EISSN: 1552-6887</identifier><identifier>DOI: 10.1177/0898264317703559</identifier><identifier>PMID: 29545676</identifier><language>eng</language><publisher>United States</publisher><subject>Aged ; Aged, 80 and over ; Databases, Factual ; Female ; Health Expenditures - trends ; Health technology assessment ; Humans ; Insurance Claim Review ; Loneliness ; Longitudinal Studies ; Male ; Medicare - economics ; Patient Acceptance of Health Care - statistics & numerical data ; Social Isolation ; United States</subject><ispartof>Journal of aging and health, 2017-10, Vol.29 (7), p.1119-1143</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,777,781,882,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29545676$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shaw, Jonathan G</creatorcontrib><creatorcontrib>Farid, Monica</creatorcontrib><creatorcontrib>Noel-Miller, Claire</creatorcontrib><creatorcontrib>Joseph, Neesha</creatorcontrib><creatorcontrib>Houser, Ari</creatorcontrib><creatorcontrib>Asch, Steven M</creatorcontrib><creatorcontrib>Bhattacharya, Jay</creatorcontrib><creatorcontrib>Flowers, Lynda</creatorcontrib><title>Social Isolation and Medicare Spending: Among Older Adults, Objective Social Isolation Increases Expenditures while Loneliness Does Not</title><title>Journal of aging and health</title><addtitle>J Aging Health</addtitle><description>Evaluate objective isolation and loneliness' impact on Medicare spending and outcomes.
We linked Health and Retirement Study data to Medicare claims to analyze objective isolation (scaled composite of social contacts and network) and loneliness (positive response to 3-item loneliness scale) as predictors of subsequent Medicare spending. In multivariable regression adjusting for health and demographics, we determined marginal differences in Medicare expenditures. Secondary outcomes included spending by setting, and mortality.
Objective isolation predicts greater spending, $1,644(p<0.001) per beneficiary annually, whereas loneliness predicts reduced spending, -$768(p<0.001). Increased spending concentrated in inpatient and nursing-home (SNF) care; despite more healthcare, objectively isolated beneficiaries had 31%(p<0.001) greater risk of death. Loneliness did not predict SNF use nor mortality, but predicted slightly less inpatient and outpatient care.
Objectively isolated seniors have higher Medicare spending, driven by increased hospitalization and institutionalization, and face greater mortality. Policies supporting social connectedness could reap significant savings.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Health Expenditures - trends</subject><subject>Health technology assessment</subject><subject>Humans</subject><subject>Insurance Claim Review</subject><subject>Loneliness</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medicare - economics</subject><subject>Patient Acceptance of Health Care - statistics & numerical data</subject><subject>Social Isolation</subject><subject>United States</subject><issn>0898-2643</issn><issn>1552-6887</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkE9P3DAQxa0KVLa0956QjxwI2E4c2z0grRZaVtp2D8A5cuzxYuS1t3GyhU_A1274q9LTzLz39HvSIPSVkmNKhTghUklWV-W4k5Jz9QFNKOesqKUUO2jyaBeP_h76lPMtIYRRQj-iPaZ4xWtRT9DDZTJeBzzPKejep4h1tPgnWG90B_hyA9H6uPqGp-sUV3gZLHR4aofQ5yO8bG_B9H475v6nzKPpQGfI-PzuidEP3Xj8ufEB8CJFCD5Czvgsjeqv1H9Gu06HDF9e5j66_n5-NbsoFssf89l0UWwopbKwuhQ1106BI0ILUitDHHdUcGG4lJxyaUzrrAGneKkFN8yJilWqra2zvCr30ekzdzO0axhzse90aDadX-vuvknaN--d6G-aVdo2XFaCCTkCDl8AXfo9QO6btc8GQtAR0pAbRmilKsVqMkYP_u16K3n9fvkXZZiKJg</recordid><startdate>201710</startdate><enddate>201710</enddate><creator>Shaw, Jonathan G</creator><creator>Farid, Monica</creator><creator>Noel-Miller, Claire</creator><creator>Joseph, Neesha</creator><creator>Houser, Ari</creator><creator>Asch, Steven M</creator><creator>Bhattacharya, Jay</creator><creator>Flowers, Lynda</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201710</creationdate><title>Social Isolation and Medicare Spending: Among Older Adults, Objective Social Isolation Increases Expenditures while Loneliness Does Not</title><author>Shaw, Jonathan G ; Farid, Monica ; Noel-Miller, Claire ; Joseph, Neesha ; Houser, Ari ; Asch, Steven M ; Bhattacharya, Jay ; Flowers, Lynda</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p1118-da3765af9ef07a7069c0f5f1757c5885158ccbfdcef953a75c2f74249b6dfd543</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Databases, Factual</topic><topic>Female</topic><topic>Health Expenditures - trends</topic><topic>Health technology assessment</topic><topic>Humans</topic><topic>Insurance Claim Review</topic><topic>Loneliness</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medicare - economics</topic><topic>Patient Acceptance of Health Care - statistics & numerical data</topic><topic>Social Isolation</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shaw, Jonathan G</creatorcontrib><creatorcontrib>Farid, Monica</creatorcontrib><creatorcontrib>Noel-Miller, Claire</creatorcontrib><creatorcontrib>Joseph, Neesha</creatorcontrib><creatorcontrib>Houser, Ari</creatorcontrib><creatorcontrib>Asch, Steven M</creatorcontrib><creatorcontrib>Bhattacharya, Jay</creatorcontrib><creatorcontrib>Flowers, Lynda</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of aging and health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shaw, Jonathan G</au><au>Farid, Monica</au><au>Noel-Miller, Claire</au><au>Joseph, Neesha</au><au>Houser, Ari</au><au>Asch, Steven M</au><au>Bhattacharya, Jay</au><au>Flowers, Lynda</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Social Isolation and Medicare Spending: Among Older Adults, Objective Social Isolation Increases Expenditures while Loneliness Does Not</atitle><jtitle>Journal of aging and health</jtitle><addtitle>J Aging Health</addtitle><date>2017-10</date><risdate>2017</risdate><volume>29</volume><issue>7</issue><spage>1119</spage><epage>1143</epage><pages>1119-1143</pages><issn>0898-2643</issn><eissn>1552-6887</eissn><abstract>Evaluate objective isolation and loneliness' impact on Medicare spending and outcomes.
We linked Health and Retirement Study data to Medicare claims to analyze objective isolation (scaled composite of social contacts and network) and loneliness (positive response to 3-item loneliness scale) as predictors of subsequent Medicare spending. In multivariable regression adjusting for health and demographics, we determined marginal differences in Medicare expenditures. Secondary outcomes included spending by setting, and mortality.
Objective isolation predicts greater spending, $1,644(p<0.001) per beneficiary annually, whereas loneliness predicts reduced spending, -$768(p<0.001). Increased spending concentrated in inpatient and nursing-home (SNF) care; despite more healthcare, objectively isolated beneficiaries had 31%(p<0.001) greater risk of death. Loneliness did not predict SNF use nor mortality, but predicted slightly less inpatient and outpatient care.
Objectively isolated seniors have higher Medicare spending, driven by increased hospitalization and institutionalization, and face greater mortality. Policies supporting social connectedness could reap significant savings.</abstract><cop>United States</cop><pmid>29545676</pmid><doi>10.1177/0898264317703559</doi><tpages>25</tpages></addata></record> |
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| ispartof | Journal of aging and health, 2017-10, Vol.29 (7), p.1119-1143 |
| issn | 0898-2643 1552-6887 |
| language | eng |
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| source | MEDLINE; SAGE Complete |
| subjects | Aged Aged, 80 and over Databases, Factual Female Health Expenditures - trends Health technology assessment Humans Insurance Claim Review Loneliness Longitudinal Studies Male Medicare - economics Patient Acceptance of Health Care - statistics & numerical data Social Isolation United States |
| title | Social Isolation and Medicare Spending: Among Older Adults, Objective Social Isolation Increases Expenditures while Loneliness Does Not |
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