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

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

Research output: Contribution to journalArticle

24 Scopus citations

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

Keywords

  • hospital readmission
  • low-income seniors
  • risk factors

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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