A Yale School of Public Health-led study using data from 622 Area Agencies on Aging (AAAs) across the United States determined that counties where these agencies have broader partnership networks with social service and health care organizations see less hospital readmissions for older adults. This is one of the first national-scale studies to link AAAs activities with potentially avoidable health care use by older adults. The findings are published in the journal Health Affairs.
Area Agencies on Aging coordinate social services for older adults across the nation and regularly address social determinants of health, often in partnership with local social service and health care organizations. By reviewing national survey data from 2013, the researchers determined the degree to which each AAAs partners with the different social service and health care organizations in its community. The study found that counties where AAAs have more partnerships also have an elderly population that is less likely to be readmitted to the hospital. In addition, counties with AAAs that have nursing home diversion programs have fewer nursing home residents with low service needs who might be served effectively at home.
“AAAs partnership behavior appears to be linked to better health outcomes for older adults, making these agencies a natural point of intervention in efforts to foster effective cross-sectoral partnerships to serve this population group,” said Dr. Amanda Brewster, the study’s lead author and associate research scientist at Yale School of Public Health.
The findings suggest that cross-sectoral partnerships involving AAAs may facilitate the provision of more effective, holistic support for older adults preventing exacerbations of ill health that might otherwise lead to hospital readmission or other types of avoidable–and costly–health care.
Dr. Brewster explained that diverse, informal partnerships maintained by an AAA may indicate a denser web of interconnection across organizations in the community, which could support the handoffs needed to help patients recover after hospital discharge and avoid rehospitalization.
“We know that social determinants like income, housing and access to nutrition are important for health, but these issues lie outside the historical purview of health care,” Dr. Brewster said. “Our findings suggest community partnerships may be a promising avenue to effectively address both social and medical determinants of health for older adults, who account for a substantial share of overall health care spending.”
Other study authors include Drs. Suzanne Kunkel and Jane Straker, both of Miami University, and Dr. Leslie Curry, a senior research scientist at the Yale School of Public Health.