The Role of Hospital Social Services in Preventing Administrative Readmissions: A Systems-Level Analysis

Abstract

Administrative hospital readmissions significantly affect patient care and healthcare system efficiency (Goodrow, 2018). Readmissions occurring within 30 days of index discharge, considered potentially avoidable and operationally undesirable, can support early identification–offering an entry point to analyze resurgent hospitalizations across the system (Obuobi et al., 2021). In discussions elucidating the contribution of hospital social services to mitigating these regressive readmissions, the system concept remains subordinate to unequal attention directed toward the clinical counterpart via two distinct notions (Love, 2013).

Ridgeway’s systems-thinking perspective envisages the problem-acquiring, anti-intentional character on distinct levels–between the community attending to a given individual’s inadequacy and the hospital resorting repetitively to a given supply of care–engendering perturbations, corrective actions, and causal sequence recursions respective to the actual dynamics. The conceptualization identifies hospitals, patients, and social services addressing structural-situational injustices and senseless suffering of material shortages and unmet needs arising therefrom as salient leverage points, thus designates both the institutional and non-institutional configurations associated with social services as systemic components capable of curbing excessive readmission. Allen et al. observe that transitional care services which encompass social-health-community integrated services, save 4–11% of the readmissions retrospective to arrival, predicting thus the probable upward flow from hospitals to transitional services, uplifting thereby further discussion of enhancing access to social services by means of the formal dimension of transitional care, enabling institutionally reinstating non-clinical avoidance of readmission as concern of practice.