Social media language of healthcare super-utilizers

Abstract

An understanding of healthcare super-utilizers’ online behaviors could better identify experiences to inform interventions. In this retrospective case-control study, we analyzed patients’ social media posts to better understand their day-to-day behaviors and emotions expressed online. Patients included those receiving care in an urban academic emergency department who consented to share access to their historical Facebook posts and electronic health records. Super-utilizers were defined as patients with more than six visits to the Emergency Department (ED) in a year. We compared posts by super-utilizers with a matched group using propensity scoring based on age, gender and Charlson comorbidity index. Super-utilizers were more likely to post about confusion and negativity (D = .65, 95% CI-[.38, .95]), self-reflection (D = .63 [.35, .91]), avoidance (D = .62 [.34, .90]), swearing (D = .52 [.24, .79]), sleep (D = .60 [.32, .88]), seeking help and attention (D = .61 [.33, .89]), psychosomatic symptoms, (D = .49 [.22, .77]), self-agency (D = .56 [.29, .85]), anger (D = .51, [.24, .79]), stress (D = .46, [.19, .73]), and lonely expressions (D = .44, [.17, .71]). Insights from this study can potentially supplement offline community care services with online social support interventions considering the high engagement of super-utilizers on social media.

Shift in Social Media App Usage During COVID-19 Lockdown and Clinical Anxiety Symptoms: Machine Learning–Based Ecological Momentary Assessment Study

“…Social networking apps, such as Facebook, Twitter, TikTok, and Instagram, are examples of web 2.0 technology apps that have shifted the recent web-based environment of health communications, from traditionally one-way communication to interactive and iterative, characterized by passive sharing, active collaboration, and amplification of information [ 46 , 47 ]. However, public digital space can expose users to unfiltered or anonymous information that promotes fear during a health crisis [ 48 ] and has been linked, as a source of COVID-19 conspiracy theories and a sign of complex social and medical needs among patients, with a number of high emergency room visits [ 49 , 50 ]. Our analysis suggests that active engagement on social networking apps is a marker of anxiety that may be associated with individual behavioral traits, perhaps activated by increasing risk perceptions of the virus and psychosocial stressors of the lockdown period.…”

Prevalence of Behavioral Flags in the Electronic Health Record Among Black and White Patients Visiting the Emergency Department

“…Patients who have frequent utilization of the ED, defined as having more than 18 visits (a yearly mean of >6 visits per calendar year, consistent with prior studies 6,7 ) during the study period were separately analyzed. Patient with frequent ED utilization are more likely to have complex behavioral health needs, have a greater number of comorbidities, and have more psychiatric admissions; thus, they were excluded for being nonrepresentative of the rest of the patient population.…”

Social Media Reveals Urban-Rural Differences in Stress across China

“…We used a validated simplified Chinese version of LIWC (Zhao et al 2016). These features have been used in several social media studies on health and well-being (Saha et al 2019;Guntuku et al 2020Guntuku et al , 2021.…”