Evidence map›Paper›PMID 38997214›Full record

ArticleJournal of the American Geriatrics Society2024

The association between social risks and days at home for older veterans.

Josephine C Jacobs, Liberty Greene, Mayuree Rao, Valerie A Smith, Courtney H Van Houtven, Matthew L Maciejewski, Donna M Zulman

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Josephine C JacobsHealth Economics Resource Center, VA Palo Alto Health Care System, Menlo Park, California, USA.
Liberty GreeneCenter for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California, USA.
Mayuree RaoSeattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington, USA.
Valerie A SmithCenter for Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, North Carolina, USA.
Courtney H Van HoutvenCenter for Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, North Carolina, USA.
Matthew L MaciejewskiCenter for Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, North Carolina, USA.
Donna M ZulmanCenter for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California, USA.

Funding

Health Services Research and Development CDA 19-120Health Services Research and Development IIR 20-114Health Services Research and Development RCS 21-137Health Services Research and Development RVR 19-472HSRD VA I01 HX003269HSRD VA IK2 HX002860HSRD VA IK6 HX003157HSRD VA IK6 HX003396VA RCS 10-391
6 · The paper itself

Abstract

backgroundMany health systems are trying to support the ability of older adults to remain in their homes for as long as possible. Little is known about the relationship between patient-reported social risks and length of time spent at home. We assessed how social risks were associated with days at home for a cohort of older Veterans at high risk for hospitalization and mortality.

methodsA prospective cross-sectional study using a 2018 survey of 3479 high-risk Veterans aged ≥65 linked to Veterans Health Administration data. Social risks included measures of social resources (i.e., no partner present, low social support), material resources (i.e., not employed, financial strain, medication insecurity, food insecurity, and transportation barriers), and personal resources (i.e., low medical literacy and less than high school education). We estimated how social risks were associated with days at home, defined as the number of days spent outside inpatient, long-term care, observation, or emergency department settings over a 12-month period, using a negative binomial regression model.

resultsNot having a partner, not being employed, experiencing transportation barriers, and low medical literacy were respectively associated with 2.57, 3.18, 3.39, and 6.14 fewer days at home (i.e., 27% more facility days, 95% confidence interval [CI] 8%-50%; 42% more facility days, 95% CI 7%-89%; 34% more facility days, 95% CI 7%-68%; and 63% more facility days, 95% CI 27%-109%). Experiencing food insecurity was associated with 2.62 more days at home (i.e., 24% fewer facility days, 95% CI 3%-59%).

conclusionsFindings suggest that screening older Veterans at high risk of community exit for social risks (i.e., social support, material resources, and medical literacy) may help identify patients likely to benefit from home- and community-based health and social services that facilitate remaining in home settings. Future research should focus on understanding the mechanisms by which these associations occur.

Indexed as

Social SupportVeteransAgedAged, 80 and overCross-Sectional StudiesFemaleFood InsecurityHospitalizationHumansMaleProspective StudiesRisk FactorsUnited StatesUnited States Department of Veterans Affairsdays at homedays in the communitysocial determinants of healthsocial risksveterans

Identifiers

PMID38997214
PMCPMC13426233

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.