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Risk Factors for Early Hospital Readmission in Low‐Income Elderly Adults
Author(s) -
Iloabuchi Tochukwu C.,
Mi Deming,
Tu Wanzhu,
Counsell Steven R.
Publication year - 2014
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12688
Subject(s) - medicine , gerontology , hospital readmission , emergency medicine
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 I ndianapolis, I ndiana. Participants Community‐dwelling adults aged 65 and older with annual income less than 200% of the federal poverty level and enrolled in the G eriatric R esources for A ssessment and C are of E lders ( 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 M edicaid ( 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.