Risk factors for hospitalization in a national sample of medicare home health care patients
| Autor: | T. Joseph Sheehan, Elizabeth A. Madigan, Richard H. Fortinsky, Alison Kleppinger, Susan Tullai-McGuinness |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Chronic condition medicine.medical_treatment Black People Sample (statistics) Outcome assessment Logistic regression Medicare Risk Assessment Article Risk Factors Acute care Home health Outcome Assessment Health Care medicine Humans Geriatric Assessment Aged Aged 80 and over Heart Failure Rehabilitation business.industry Depression medicine.disease Home Care Services United States Hospitalization Heart failure Family medicine Emergency medicine Chronic Disease Wounds and Injuries Female Geriatrics and Gerontology business Gerontology |
| Zdroj: | Journal of applied gerontology : the official journal of the Southern Gerontological Society. 33(4) |
| ISSN: | 1552-4523 |
| Popis: | Acute care hospitalization during or immediately following a Medicare home health care (HHC) episode is a major adverse outcome, but little has been published about HHC patient-level risk factors for hospitalization. The authors determined risk factors at HHC admission associated with subsequent acute care hospitalization in a nationally representative Medicare patient sample ( N = 374,123). Hospitalization was measured using Medicare claims data; risk factors were measured using Outcome Assessment and Information Set data. Seventeen percent of sample members were hospitalized. Multivariate logistic regression analysis found that the most influential risk factors (all p < .001) were skin wound as primary HHC diagnosis, clinician-judged guarded rehabilitation prognosis, congestive heart failure as primary HHC diagnosis, presence of depressive symptoms, dyspnea severity, and Black, compared to White. HHC initiatives that minimize chronic condition exacerbations and actively treat depressive symptoms might help reduce Medicare patient hospitalizations. Unmeasured reasons for higher hospitalization rates among Black HHC patients deserve further investigation. |
| Databáze: | OpenAIRE |
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