Verena R Cimarolli1, Francesca Falzarano2, Stephanie Hicks3. 1. LeadingAge LTSS Center @UMass Boston, Washington, DC. Electronic address: vcimarolli@leadingage.org. 2. Department of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, NY. 3. School of Professional Studies, Columbia University, New York, NY.
Abstract
OBJECTIVES: Previous research has shown that ethnicity may play a role in increased risk for hospital readmission during a post-acute rehabilitation care (PARC) stay. However, little is known about risk factors influencing discharge status from PARC settings among different ethnic groups. Hence, the aim of our study was to investigate the relationship of individual characteristics (eg, sex, neighborhood quality) and health behavior (use of rehabilitation services) with rehospitalization across ethnic groups of older adult patients who received post-acute rehabilitation for a cardiovascular disease at a skilled nursing facility (SNF). DESIGN: Retrospective study with data extraction from electronic medical records (EMRs) at admission and discharge. SETTING: SNF. PARTICIPANTS: The sample consisted of 520 post-acute rehabilitation patients (96 Hispanics, 172 African Americans, and 252 Whites) 60 years or older with an admitting condition of a circulatory-related disease. MEASUREMENTS: Sociodemographic and health-related variables, and discharge status (rehospitalized or home). RESULTS: For the Hispanic sample, lower community quality was associated with a greater likelihood of being rehospitalized. For African Americans, having no social support, higher levels of admission functional dependency, and shorter length of stay were significantly associated with a higher likelihood of being rehospitalized. For the group of White participants, the following variables emerged as risk factors for rehospitalization: being male, lower admission cognitive functioning, higher levels of admission depressive symptomatology, and shorter length of stay. CONCLUSIONS/IMPLICATIONS: Individual characteristics and health behaviors that are risk factors for rehospitalization during a post-acute stay vary across ethnic groups. Hence, the study provides insights for PARC clinicians into specific patient characteristics to be aware of as risk factors for less optimal patient outcomes.
OBJECTIVES: Previous research has shown that ethnicity may play a role in increased risk for hospital readmission during a post-acute rehabilitation care (PARC) stay. However, little is known about risk factors influencing discharge status from PARC settings among different ethnic groups. Hence, the aim of our study was to investigate the relationship of individual characteristics (eg, sex, neighborhood quality) and health behavior (use of rehabilitation services) with rehospitalization across ethnic groups of older adult patients who received post-acute rehabilitation for a cardiovascular disease at a skilled nursing facility (SNF). DESIGN: Retrospective study with data extraction from electronic medical records (EMRs) at admission and discharge. SETTING: SNF. PARTICIPANTS: The sample consisted of 520 post-acute rehabilitation patients (96 Hispanics, 172 African Americans, and 252 Whites) 60 years or older with an admitting condition of a circulatory-related disease. MEASUREMENTS: Sociodemographic and health-related variables, and discharge status (rehospitalized or home). RESULTS: For the Hispanic sample, lower community quality was associated with a greater likelihood of being rehospitalized. For African Americans, having no social support, higher levels of admission functional dependency, and shorter length of stay were significantly associated with a higher likelihood of being rehospitalized. For the group of White participants, the following variables emerged as risk factors for rehospitalization: being male, lower admission cognitive functioning, higher levels of admission depressive symptomatology, and shorter length of stay. CONCLUSIONS/IMPLICATIONS: Individual characteristics and health behaviors that are risk factors for rehospitalization during a post-acute stay vary across ethnic groups. Hence, the study provides insights for PARC clinicians into specific patient characteristics to be aware of as risk factors for less optimal patient outcomes.
Authors: Joshua Chodosh; Maria Orlando Edelen; Joan L Buchanan; Julia Ann Yosef; Joseph G Ouslander; Dan R Berlowitz; Joel E Streim; Debra Saliba Journal: J Am Geriatr Soc Date: 2008-11 Impact factor: 5.562
Authors: Heather S Lett; James A Blumenthal; Michael A Babyak; Diane J Catellier; Robert M Carney; Lisa F Berkman; Matthew M Burg; Pamela Mitchell; Allan S Jaffe; Neil Schneiderman Journal: Health Psychol Date: 2007-07 Impact factor: 4.267