The Social Admission Pathway: A Multidisciplinary Strategy for Medically Unnecessary but Socially Complex Hospitalizations
Abstract
Background: A significant portion of acute hospitalizations among older adults and marginalized populations is often prolonged by social complexities rather than medical necessity, a phenomenon known as "social admission." Patients experiencing homelessness, unsafe living conditions, caregiver shortages, or severe functional decline frequently occupy hospital beds for extended periods while waiting for social placements, leading to high costs and potential harm. This highlights a critical failure within the integration of clinical care and social infrastructure. Aim: This narrative review aims to identify, manage, and prevent socially complex hospitalizations by addressing non-medical barriers to discharge and community living. Methods: A comprehensive search of PubMed, Scopus, CINAHL, and social science databases was conducted. Results: Effective interventions in healthcare necessitate early identification by medical staff, thorough assessments by social workers, simplified medication access, support from health assistants, and strategic planning based on health security principles. Models like complex discharge teams and hospital-hotels have been shown to reduce length of stay by 20-40% and lower emergency department recidivism by integrating social care within clinical workflows and dismantling barriers between clinical and social services. Conclusion: The "social admission" highlights issues within a fragmented health and social care system. Addressing this requires redefining hospital responsibilities and investing in interdisciplinary teams equipped to tackle social problems, ensuring that hospital beds are used for medically necessary purposes.
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Authors
Copyright (c) 2024 Munira Mohammed I Albyahi, Alhnouf Adel Saad Alkhayat, Mariam Hatab Alrowaily, Mohammed Saad Saeed Aladhyani, Mansor Mohammad Al Mansor, Sultan Raja M Alanazi, Jafer Ali Mahnashi, Mohammed Saad Mousa Alosum, Amjad Abdullah Rizkan Almukhlif, Faris Salamh Aljohani, Mohammed Saleh Saleem Alraddadi, Razan Aiydh Abu Hassan
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