BACKGROUND: Older adults of low socioeconomic status are at high risk for poor post-hospital outcomes. Design. A qualitative researcher, who was also an outreach worker from the West Philadelphia community, conducted in-depth interviews with 25 participants within 30 days of their hospital discharge. PARTICIPANTS: Eligible participants were: 1) residents of high-poverty ZIP codes; 2) dually eligible for Medicare and Medicaid; 3) had capacity or a caregiver who could be interviewed as a proxy; 4) general medicine or cardiology patients. RESULTS: Participants were unable to access the care and accommodations needed to cope with post-hospital frailty. As a result, medical disability was amplified by socioeconomic disability. Participants were ashamed of the resulting loss of control and had difficulty asking for help, particularly from potential supports who were perceived as emotionally controlling or judgmental. CONCLUSION: Strategies that address socioeconomic stressors of hospitalization and provide empathic support may improve the post-hospital transition for these high-risk individuals.
BACKGROUND: Older adults of low socioeconomic status are at high risk for poor post-hospital outcomes. Design. A qualitative researcher, who was also an outreach worker from the West Philadelphia community, conducted in-depth interviews with 25 participants within 30 days of their hospital discharge. PARTICIPANTS: Eligible participants were: 1) residents of high-poverty ZIP codes; 2) dually eligible for Medicare and Medicaid; 3) had capacity or a caregiver who could be interviewed as a proxy; 4) general medicine or cardiology patients. RESULTS:Participants were unable to access the care and accommodations needed to cope with post-hospital frailty. As a result, medical disability was amplified by socioeconomic disability. Participants were ashamed of the resulting loss of control and had difficulty asking for help, particularly from potential supports who were perceived as emotionally controlling or judgmental. CONCLUSION: Strategies that address socioeconomic stressors of hospitalization and provide empathic support may improve the post-hospital transition for these high-risk individuals.
Authors: Andrew Finkel Beck; Lauren G Solan; Stephanie A Brunswick; Hadley Sauers-Ford; Jeffrey M Simmons; Samir Shah; Jennifer Gold; Susan N Sherman Journal: BMJ Qual Saf Date: 2016-07-28 Impact factor: 7.035
Authors: David T Liss; Ronald T Ackermann; Andrew Cooper; Emily A Finch; Courtney Hurt; Nicola Lancki; Angela Rogers; Avani Sheth; Caroline Teter; Christine Schaeffer Journal: J Gen Intern Med Date: 2019-05-29 Impact factor: 5.128
Authors: Mary Malebranche; Apostolos Sarivalasis; Solange Peters; Patrice Mathevet; Jacques Cornuz; Patrick Bodenmann Journal: J Prim Care Community Health Date: 2020 Jan-Dec