Social vulnerability in urban and suburban hospitalized patient: the importance of an early detection

The “Triage Sociale” project was developed by “Sapienza – University of Rome” and the regional institution – “Regione Lazio”, and implemented in nine hospitals of Rome, six Hospital Trusts (Aziende Ospedaliere) and three smaller District Hospitals (Presidi Ospedalieri), five in the suburbs and four in the inner city. The project aimed at hindering the transversal social vulnerability that can cause inequality in the health care services. The purpose of this partnership was to enhance the hospital awareness regarding the importance of inserting a social evaluation concurrent, in the first day of admission, to the health assessment of hospitalized patient. We have developed an evaluative tool, capable of promptly detecting potential social vulnerabilities. These issues are indeed prone to be overlooked during the hospitalization, which cause frequently admission to hospital or prolonged recoveries with delayed discharges. The study has been conducted through 8,282 forms, filled out by properly trained nurses at the bedside. We collected 1,005 positive forms of the total 8,282. It means that the 12% of admitted patients could have a potential exposure to social fragility (regarding the dimensions of: housing, income or informal support network). We found a statistically significant difference (p<0.001) in the proportion of positive forms between hospitals, and a statistically significant difference (p<0.001) between Hospital Trusts and District Hospitals. On the other way there is no statistical difference between inner hospitals and suburban hospitals. This is probably because, two of the four suburban hospitals are Hospital Trusts. We could ascribe this difference of positive cases between different kind of structure is due to the different complexity of cases treated in those structures. Further statistical elaborations need to be performed, but we could reasonably suppose that the absence of differences between inner and suburban hospitals is due to the overlapping of the catchment area of those hospitals.