Neighborhood matters for transitional care and heart failure hospital readmission in older adults

Abstract

A retrospective correlational design with existing data was utilized to examine the relationship between early provider follow-up, nursing care coordination intensity, and 30-day hospital readmission in older adults with heart failure and determine if an interaction exists with neighborhood disadvantage. Forward logistic regression was conducted to determine which variables predicted early provider follow-up and readmission. Ordinary least squares regression, logistic regression, and bootstrap confidence intervals were used to test for mediation and moderation. A direct relationship between early provider follow-up and decreased readmission was identified, but no indirect relationship through care coordination intensity. Neighborhood disadvantage did not moderate the effect of provider follow-up on readmission. Early provider follow-up and care coordination intensity were related and moderated by neighborhood disadvantage, but not for those living in highly disadvantaged neighborhoods. Neighborhood disadvantage is a key factor that may negatively influence participation in transitional care interventions in the elderly heart failure population.