Innovative solutions to a vexing issue: “social admissions”

On this episode of the CMAJ Podcast, Dr. Blair Bigham and Dr. Mojola Omole tackle the complex issue of "socially admitted" patients, sometimes uncharitably referred to as "granny dumping." They explore the factors leading to these non-acute medical admissions, the challenges faced by healthcare providers and innovative solutions to the problem.

Dr. Jasmine Mah, a geriatrics fellow at Dalhousie University, shares insights from her qualitative study published in CMAJ, titled "Managing “socially admitted” patients in hospital: a qualitative study of healthcare providers' perceptions". She provides examples of typical “social admissions”, such as patients with chronic conditions whose care circumstances have changed, and highlights the high mortality rates associated with these cases.

The discussion moves to the attitudes of healthcare providers towards “socially admitted” patients, the systemic failures leading to these admissions, and potential solutions. Dr. Mah emphasizes the need for better understanding and support for these patients, suggesting systemic changes like integrating social vulnerability into case mix indices and improving community care to prevent unnecessary hospital admissions.

Dr. Andrew Boozary, a primary care physician and executive director of the Gattuso Center for Social Medicine at University Health Network in Toronto, expands on these ideas in an editorial response. He underscores that these issues are not personal failures but policy failures, advocating for increased support roles like peer support workers and social medicine navigators. Dr. Boozary highlights the importance of innovative team-based care models to address the gaps in the current healthcare system.

Throughout the episode, the hosts and guests call for a more integrated and empathetic approach to patient care, stressing the need for systemic changes to better manage “socially admitted” patients and improve overall healthcare outcomes.

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