LAUSR

The present prospective cohort study investigated the association of loneliness and social isolation with healthcare utilisation in the general population over time. We also investigated the synergistic effect of loneliness and social isolation on healthcare utilisation. Data from the 2013 Danish “How are you?' survey (n = 29,472) were combined with individual-level register data from the National Danish Patient Registry and the Danish National Health Service Registry in a 6-year follow-up period (2013-2018). Negative binomial regression analyses were performed while adjusting for baseline demographics, chronic disease, and healthcare utilisation during the follow-up period. Loneliness was significantly associated with number of GP visits (incident-rate ratio (IRR) = 1.06, 95% confidence interval (CI) [1.01, 1.13]), emergency admissions (IRR = 1.19, 95% CI [1.03, 1.37]) and number of hospital admission days (IRR = 1.32, 95% CI [1.08, 1.62]). No significant associations were found between social isolation and healthcare utilisation with one minor exception, in which social isolation was associated with less planned admissions (IRR = .88, 95% CI [.78, .99]). Finally, loneliness and social isolation demonstrated a synergistic effect on number of visits to the GP (IRR = .87, 95% CI [.78, .98]) and number of hospital admission days (IRR = .67, 95% CI [.45, .98]). Our findings suggest that loneliness is a risk factor for primary and secondary healthcare utilisation, independently of social isolation, baseline demographics, chronic disease, and healthcare utilisation during the follow-up period. Loneliness is an independent risk factor for healthcare utilisation in the general population. Social isolation is not associated with healthcare utilisation in the general population.