Risk factor assessment of hospice patients who are readmitted within 7 days of acute care hospital discharge.

Abstract

121 Background: Although 20% of adults 65 and older are re-hospitalized within 30 days of discharge, there is a dearth of research investigating readmission of patients discharged to hospice and the predictors of the readmissions. The study aim was to identify risk factors for hospital readmission within 7 days of discharge to home hospice. Methods: This was a retrospective case control study with cases being patients discharged to home hospice that were readmitted to the hospital within 7 days. Controls were patients discharged to home hospice and not readmitted to the hospital within 7 days. Descriptive statistics were used to describe demographic and clinical characteristics. The chi-square or Fisher’s Exact test were used to compare categorical predictors between cases and controls. The two-sample t-test or the Mann-Whitney test were used to compare continuous predictors between cases and controls. Results: There were 163 subjects; 46 cases (28.22%) and 117 controls (71.78%). The most frequent hospital diagnosis was cancer (56.4%). There was a significant association between 7-day readmission (i.e., case) and age (P < 0.0041), race (P < 0.0008), language (P < 0.0007) and insurance (P < 0.0001). Specifically, cases were significantly younger than controls (69.5 vs. 77.0). Cases were more likely to be Hispanic (15.2 vs. 5.1), Asian (15.2 vs. 5.1) and other (13.0 vs. 2.6) when compared to controls. Cases were more likely to speak Spanish (13.3 vs. 3.5) or other (20.0 vs. 5.3) and less likely to speak English (66.7 vs. 91.2). Cases were less likely to have Medicare (8.7 vs. 82.9) and more likely to have Medicaid (32.6 vs. 4.3), private insurance (13.0 vs. 10.3) or other form of insurance including dual eligibility (45.7 vs. 2.6). Gender, marital status, religion, hospital diagnosis, discharge day, family support at home, symptoms and emergency contact relationship were not significantly association with 7-day readmission. Conclusions: Our data highlights four risk factors, namely age, race, language and insurance status as factors predicting readmission within seven days of acute care hospital discharge. Further study of these predictors may identify opportunities for interventions to obviate these readmissions.