Early hospital readmission of nursing home residents and community-dwelling elderly adults discharged from the geriatrics service of an Urban teaching hospital: Patterns and risk factors

Michael Bogaisky, Laurel Dezieck

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Objectives To compare rates and risk factors for early hospital readmission for nursing home residents and community-dwelling older adults. Design Retrospective cohort study. Setting Geriatric inpatient service at a large urban hospital. Participants Nursing home residents (n = 625) and community-dwelling individuals (n = 413) aged 65 and older admitted over a 1-year period. Measurements Thirty-day readmissions. Results There were 1,706 hospital admissions within the 1-year study period involving 1,038 individuals. The 30-day readmission rate was higher for subjects discharged to a nursing home than those discharged to the community (34.4% vs 22.6%, P <.001). Chronic kidney disease and pressure ulcers were associated with greater risk of readmission in both groups. Chronic obstructive pulmonary disease was a risk factor for readmission only in community-dwelling individuals. Congestive heart failure and dementia were associated with greater risk of readmission only in nursing home residents. Readmission rates varied between individual nursing homes by more than a factor of 2. Risk of readmission was 30% lower in nursing home residents cared for by hospitalist than nonhospitalist geriatricians. Conclusion Higher rates of hospital readmission for individuals discharged to nursing homes than to the community and differing patterns of risk factors for readmission indicate the importance of customized interventions to reduce readmission rates for two distinct elderly populations.

Original languageEnglish (US)
Pages (from-to)548-552
Number of pages5
JournalJournal of the American Geriatrics Society
Volume63
Issue number3
DOIs
StatePublished - Mar 1 2015

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Independent Living
Patient Readmission
Urban Hospitals
Nursing Homes
Teaching Hospitals
Geriatrics
Hospitalists
Pressure Ulcer
Chronic Renal Insufficiency
Chronic Obstructive Pulmonary Disease
Dementia
Inpatients
Cohort Studies
Heart Failure
Retrospective Studies

Keywords

  • elderly
  • hospital readmission
  • nursing home resident

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Medicine(all)

Cite this

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title = "Early hospital readmission of nursing home residents and community-dwelling elderly adults discharged from the geriatrics service of an Urban teaching hospital: Patterns and risk factors",
abstract = "Objectives To compare rates and risk factors for early hospital readmission for nursing home residents and community-dwelling older adults. Design Retrospective cohort study. Setting Geriatric inpatient service at a large urban hospital. Participants Nursing home residents (n = 625) and community-dwelling individuals (n = 413) aged 65 and older admitted over a 1-year period. Measurements Thirty-day readmissions. Results There were 1,706 hospital admissions within the 1-year study period involving 1,038 individuals. The 30-day readmission rate was higher for subjects discharged to a nursing home than those discharged to the community (34.4{\%} vs 22.6{\%}, P <.001). Chronic kidney disease and pressure ulcers were associated with greater risk of readmission in both groups. Chronic obstructive pulmonary disease was a risk factor for readmission only in community-dwelling individuals. Congestive heart failure and dementia were associated with greater risk of readmission only in nursing home residents. Readmission rates varied between individual nursing homes by more than a factor of 2. Risk of readmission was 30{\%} lower in nursing home residents cared for by hospitalist than nonhospitalist geriatricians. Conclusion Higher rates of hospital readmission for individuals discharged to nursing homes than to the community and differing patterns of risk factors for readmission indicate the importance of customized interventions to reduce readmission rates for two distinct elderly populations.",
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