Examining associations of social disconnectedness change patterns with subsequent healthcare utilization and costs among public healthcare users in Central Singapore

Social disconnectedness contributes to adverse health outcomes, yet how patterns of change in social disconnectedness are associated with healthcare utilization and costs in Singapore remains underexplored. Data from a longitudinal population health survey were linked with an institutional administrative database. Four patterns of change in social disconnectedness were derived from social isolation (Lubben Social Network Scale-6) and loneliness (three-item UCLA Loneliness Scale) statuses measured at two annual waves. Healthcare utilization and cost outcomes were extracted for 1- and 3-year (cumulative) after wave 2. Participant characteristics at wave 1 formed the baseline and were compared using Chi-square or Kruskal–Wallis tests. The associations between change patterns and subsequent healthcare utilization and costs were respectively examined using two-step hurdle models, adjusting for covariates. Persistent social disconnectedness (16.9% out of 1182 participants) was associated with increased odds of hospitalizations and emergency department (ED) visits and costs, and polyclinic visits, at both follow-ups, compared to participants who remained socially connected (56.7%). Participants who became socially connected (15.2%) exhibited higher odds of hospitalization at 3-year follow-up and higher odds of ED visits and costs at both follow-ups. Among public healthcare users, promoting social connectedness may help reduce costly hospitalizations and ease resource strains on polyclinic services.