Factors associated with unplanned hospital readmission among patients 65 years of age and older in a medicare managed care plan.
Unplanned hospital readmission within 30 days of discharge is considered a « sentinel event » for poor quality.
Patients at high risk for this adverse event could be targeted for interventions designed to reduce their risk of readmission.
The purpose of this study was to identify patient characteristics and risk factors at discharge associated with unplanned readmission within 30 days of hospital discharge.
SUBJECTS AND METHODS
We performed a matched case-control study among patients in a Medicare managed care plan who had been admitted to an academic hospital.
The cases were patients aged 65 years or older who were urgently or emergently readmitted to the hospital within 30 days of discharge.
One control patient who was not readmitted within 30 days was matched to each case by principal diagnosis.
The medical records of the first admission of the cases and the admission of the controls underwent review (blinded to case-control status) to determine the patient's baseline demographic characteristics, comorbid conditions, previous health care utilization, and functional status.
The records were also reviewed to assess risk factors on discharge, including clinical instability, inability to ambulate and feed, mental status changes, number of discharge medications, and discharge disposition.
Five factors were independently associated (P<0.05) with unplanned readmission within 30 days. (...)
Mots-clés Pascal : Personne âgée, Homme, Hospitalisation, Facteur risque, Récidive, Temps attente, Etats Unis, Amérique du Nord, Amérique, Evaluation, Pronostic, Association morbide, Etat dépressif, Relation médecin malade
Mots-clés Pascal anglais : Elderly, Human, Hospitalization, Risk factor, Relapse, Waiting time, United States, North America, America, Evaluation, Prognosis, Concomitant disease, Depression, Physician patient relation
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0398243
Code Inist : 002B30A03B. Création : 22/03/2000.