Risk Factors for Early Hospital Readmission in Low-Income Elderly Adults
- Autores: Tochukwu C. Iloabuchi, Deming Mi, Wanzhu Tu, Steven R. Counsell
- Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 62, Nº. 3, 2014, págs. 489-494
- Idioma: inglés
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Resumen
Objectives: To identify risk factors for early hospital readmission in low-income community-dwelling older adults.
Design: Prospective cohort study.
Setting: University-affiliated urban safety-net healthcare system in Indianapolis, Indiana.
Participants: Community-dwelling adults aged 65 and older with annual income less than 200% of the federal poverty level and enrolled in the Geriatric Resources for Assessment and Care of Elders (GRACE) randomized controlled trial (N = 951).
Measurements: Participant health and functional status at baseline and 6, 12, 18, and 24 months. Early readmission was defined as a repeat hospitalization occurring within 30 days of a prior hospital discharge. Candidate risk factors included sociodemographic characteristics, health and functional status, prior care, lifestyle, and satisfaction with care.
Results: Of 457 index admissions in 328 participants, 85 (19%) were followed by an early readmission. The independent risk factors for early readmission identified according to regression analysis were living alone (odds ratio (OR) = 1.71, 95% confidence interval (CI) = 1.02�2.87), fair or poor satisfaction with primary care physician (OR = 2.12, 95% CI = 1.01�4.46), not having Medicaid (OR = 1.80, 95% CI = 1.05�3.11), receiving a new assistive device in the past 6 months (OR = 2.26, 95% CI = 1.26�4.05), and staying in a nursing home in the past 6 months (OR = 5.08, 95% CI = 1.56�16.53). Age, race, sex, education, and chronic diseases were not associated with early readmission.
Conclusion: A broad range of nonmedical risk factors played a greater role than previously recognized in early hospital readmission of low-income seniors.
