Social Determinants of Health and Hospital Readmission

Hospital readmissions are influenced not only by patients’ health status but also by access to resources such as income, insurance, and social support systems. Optimizing hospital discharge education, planning, and care coordination with outpatient providers are essential strategies to prevent avoidable hospital readmissions.1 Researchers also suggest hospitals should consider social determinants of health (SDH) when assessing readmission risk.2 SDH can be defined as the conditions in which people are born, live, work, and age, and are shaped by the distribution of money, power, and resources.3 Research reveals that SDH contribute to an elevated burden of disease in affected children.4 Children in poverty who experience housing insecurity, food insecurity, and low rates of parental education have higher rates of hospital readmission.5 Recent studies reveal that race and/or ethnicity and household income are predictors of pediatric readmissions.1,5,6

We present a case in which lack of comprehensive screening for SDH contributed to a hospital readmission. We share the perspectives of the patient’s mother, the primary care physician, and a pediatric resident involved in the hospitalization and offer suggestions for collaborative interventions to prevent potentially avoidable hospital readmissions that may be driven by SDH.

Publication Date: 
2017
Journal Name: 
AAP News & Journals