Abstract
CONTEXTSocial isolation and comorbidities are likely to have a significant level of influence on the healthcare use patterns of geriatric patients with ongoing congestive heart failure (CHF)-related needs.METHODSA retrospective study was conducted in a specialized emergency department (ED) with a sample of 286 geriatric CHF patients who initially received CHF-related care over a six-month period. Social isolation levels were assessed using a pre-existing four-point screening tool used in the study setting and composite comorbidity was gauged using the Charlson Comorbidity Index method. Subjects were categorized into either “less than 30-day readmission” or “greater than 30-day readmission/non-readmitted” sample subgroups. The setting was a single 304-bed community hospital with approximately 45,000 annual ED visits. The analytic sample was comprised of geriatric patients 65+ years of age with an ICD-9 code corresponding to CHF.RESULTSThere were no statistically significant differences between earlier hospital readmission versus later/non-readmitted sample patients when grouped by age, race, gender or level of measured social isolation. However, composite comorbidity scores were significantly lower for patients in the >30-day/non-readmitted subgroup compared to earlier readmission patients.CONCLUSIONSThese initial study results suggest that a larger proportion of CHF hospital readmissions may be more heavily influenced by clinical factors than social living arrangements. Future studies with larger samples and validated measures of social isolation are needed to inform the development and testing of programs for geriatric CHF patients striving to avoid unnecessary hospital readmissions and adverse health outcomes.
Highlights
The geriatric population in the U.S is rapidly growing.[1]
In addition to the monetary burden placed on patients and hospitals, readmissions often severely disrupt the well-being of congestive heart failure (CHF) patients and families
An important example of this phenomenon concerns how admissions and readmissions for the diagnostic related group (DRG) amount of CHF is routinely associated with especially high healthcare costs
Summary
The geriatric population in the U.S is rapidly growing.[1]. Geriatric patients who are 65 years and older tend to be concentrated users of the health care system.[2]. An important example of this phenomenon concerns how admissions and readmissions for the diagnostic related group (DRG) amount of CHF is routinely associated with especially high healthcare costs. This chronic condition alone accounts for 6.5 million annual hospitalizations in geriatric patients and directly/indirectly accounts for 60-70% of their hospital admissions.[5] Medicare penalizes hospitals for excessive 30-day readmissions for CHF.[6]
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