Dr. Bhupin Butaney, is a board-certified clinical psychologist in independent practice in Scottsdale, Arizona, and a Professor in the Clinical Psychology Program at Midwestern University. He serves in national leadership roles within the American Psychological Association, including as President of APA's Division of Psychologists in Independent Practice, and has served on numerous boards, committees, and professional initiatives dedicated to advancing the profession. His clinical, teaching, and leadership work focuses on promoting excellence in psychological practice, professional development, and patient care. He is also Televeda's Chief Scientific Officer.
I often think about a patient I will call Mrs. H. She left the hospital with everything her care team expected her to need. Her medications had been reviewed, her follow up visit was scheduled, and her discharge instructions were clear. Three weeks later, she was back in the emergency department.
Her medical record did not explain what had happened. A longer conversation did. She had no one checking on her, no transportation to her appointment, and no confidence that anyone would notice if her condition worsened.
Her experience is a reminder that healthcare does not end when a patient leaves the hospital. Recovery continues at home, where people manage medications, meals, transportation, symptoms, and follow up care. Even an excellent clinical plan can fall apart when a patient has little practical or emotional support.
Loneliness often kills motivation for life. It is easy to miss because it does not appear on a laboratory report. It is also often misunderstood. Loneliness is the feeling that the relationships in a person's life do not provide the connection they need. Social isolation is different. It refers to having limited social contact. A person can live alone and feel supported or be surrounded by others and feel completely disconnected.
Healthcare teams are trained to notice medical instability. We look for changes in laboratory values, symptoms, and medication needs. Dependable support is harder to assess and may remain hidden unless someone asks how the patient will manage at home. These conversations often reveal risks that were never visible in the chart.
This distinction matters after discharge, when patients are especially vulnerable. A family member, friend, neighbor, or community contact may notice a change in symptoms, help with transportation, pick up a prescription, or encourage someone to call the doctor. Without this support, even a manageable problem can become a crisis.
Recent research suggests that loneliness and social isolation may be related to healthcare use in different but overlapping ways. In a study of more than 6,800 older adults, Gao, Mak, and Fancourt (2024) found that loneliness was associated with more physician visits, while social isolation was associated with longer hospital and nursing home stays. Hou and colleagues (2026) found that social isolation was associated with 37% greater inpatient use, while loneliness was linked to 15% more emergency department visits and 13% greater inpatient use. Barnes and colleagues (2022) also found that people experiencing both loneliness and social isolation had more emergency department visits and somewhat higher medical costs, even after other factors were considered. Although these studies do not establish causation, they highlighted an important connection between social well-being and healthcare use.
For health plans and provider organizations, the first step is asking better questions. Does the patient have someone to call for help? Is there someone who checks in regularly? Can the patient get to the pharmacy and follow up appointments? Does the patient often feel lonely? These questions may uncover risks that a claims report or clinical score will never capture.
These questions also need to become part of care. They can be included in discharge planning, care management calls, and early follow up after a patient returns home. Asking about transportation, food, medication access, and social support may reveal more about readmission risk than another review of the diagnosis. The purpose is to notice when a patient needs help and make sure someone follows through.
Screening only matters when it leads to help. One patient may need transportation. Another may benefit from a caregiver resource, a community group, behavioral health care, or regular contact with a peer. The right response depends on the person. The goal is not to fill a calendar with activities. It is to understand what is getting in the way of recovery and connect the patient with support that is useful and realistic.
Follow up matters. Bilicki and Reeves (2024) found that outpatient follow up visits were associated with a lower risk of readmission for several common conditions, although results varied across studies. Scheduling the appointment is important, but patients still need a realistic way to attend it. A plan is only as useful as the patient's ability to carry it out.
There is also a practical reason for healthcare organizations to pay attention. Value based care depends on helping patients follow treatment plans and avoid preventable complications. Social support will never replace good medical care, but it can make good medical care easier to carry into daily life.
Medicine has always understood that healing happens through relationships. Research is giving us clearer evidence of how much those relationships matter after a patient goes home. When someone returns to the hospital, we should look beyond the diagnosis and ask what happened in the days in between.
Loneliness should not be treated as an afterthought. It is a quiet health risk, but it is also one we can identify and address. When we understand who is present in a patient's life, who is missing, and what support is within reach, we have a better chance of helping that person recover and stay well.
Curious how Televeda helps health plans and providers screen for loneliness and close the loop after discharge? Book a demo with our team.
References
Bilicki, D. J., & Reeves, M. J. (2024). Outpatient follow-up visits to reduce 30-day all-cause readmissions for heart failure, COPD, myocardial infarction, and stroke: A systematic review and meta-analysis. Preventing Chronic Disease, 21, 240138. https://doi.org/10.5888/pcd21.240138
Barnes, T. L., MacLeod, S., Tkatch, R., Ahuja, M., Albright, L., Schaeffer, J. A., & Yeh, C. S. (2022). Cumulative effect of loneliness and social isolation on health outcomes among older adults. Aging & Mental Health, 26(7), 1327–1334. https://doi.org/10.1080/13607863.2021.1940096
Gao, Q., Mak, H. W., & Fancourt, D. (2024). Longitudinal associations between loneliness, social isolation, and healthcare utilisation trajectories: A latent growth curve analysis. Social Psychiatry and Psychiatric Epidemiology, 59, 1839–1848. https://doi.org/10.1007/s00127-024-02639-9
Hou, T., Ho, M.-H., Lederman, Z., Cheung, D. S. T., Rainer, T. H., & Lin, C.-C. (2026). Associations of social isolation and loneliness with healthcare utilization among older adults: A systematic review and meta-analysis. Innovation in Aging, 10(1), igaf136. https://doi.org/10.1093/geroni/igaf136
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