Risk factors for early hospital readmission in low-income elderly adults

Tochukwu C. Iloabuchi, Deming Mi, Wanzhu Tu, Steven Counsell

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)489-494
Number of pages6
JournalJournal of the American Geriatrics Society
Volume62
Issue number3
DOIs
StatePublished - 2014

Fingerprint

Patient Readmission
Odds Ratio
Confidence Intervals
Independent Living
Health Status
Geriatric Assessment
Self-Help Devices
Sex Education
Medicaid
Primary Care Physicians
Poverty
Nursing Homes
Life Style
Hospitalization
Chronic Disease
Cohort Studies
Randomized Controlled Trials
Regression Analysis
Prospective Studies
Delivery of Health Care

Keywords

  • hospital readmission
  • low-income seniors
  • risk factors

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Risk factors for early hospital readmission in low-income elderly adults. / Iloabuchi, Tochukwu C.; Mi, Deming; Tu, Wanzhu; Counsell, Steven.

In: Journal of the American Geriatrics Society, Vol. 62, No. 3, 2014, p. 489-494.

Research output: Contribution to journalArticle

@article{265054785c7245d08c5f80d60304abd0,
title = "Risk factors for early hospital readmission in low-income elderly adults",
abstract = "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.",
keywords = "hospital readmission, low-income seniors, risk factors",
author = "Iloabuchi, {Tochukwu C.} and Deming Mi and Wanzhu Tu and Steven Counsell",
year = "2014",
doi = "10.1111/jgs.12688",
language = "English",
volume = "62",
pages = "489--494",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Risk factors for early hospital readmission in low-income elderly adults

AU - Iloabuchi, Tochukwu C.

AU - Mi, Deming

AU - Tu, Wanzhu

AU - Counsell, Steven

PY - 2014

Y1 - 2014

N2 - 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.

AB - 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.

KW - hospital readmission

KW - low-income seniors

KW - risk factors

UR - http://www.scopus.com/inward/record.url?scp=84896399147&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84896399147&partnerID=8YFLogxK

U2 - 10.1111/jgs.12688

DO - 10.1111/jgs.12688

M3 - Article

C2 - 24576082

AN - SCOPUS:84896399147

VL - 62

SP - 489

EP - 494

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

SN - 0002-8614

IS - 3

ER -