Discharge home health services referral and 30-day all-cause readmission in older adults with heart failure

Archives of Medical Science : AMS
Cherinne ArundelAli Ahmed

Abstract

Heart failure (HF) is the leading cause of hospital readmission. Medicare home health services provide intermittent skilled nursing care to homebound Medicare beneficiaries. We examined whether discharge home health referral is associated with a lower risk of 30-day all-cause readmission in HF. Of the 8049 Medicare beneficiaries hospitalized for acute HF and discharged alive from 106 Alabama hospitals, 6406 (76%) patients were not admitted from nursing homes and were discharged home without discharge hospice referrals. Of these, 1369 (21%) received a discharge home health referral. Using propensity scores for home health referral, we assembled a matched cohort of 1253 pairs of patients receiving and not receiving home health referrals, balanced on 33 baseline characteristics. The 2506 matched patients had a mean age of 78 years, 61% were women, and 27% were African American. Thirty-day all-cause readmission occurred in 28% and 19% of matched patients receiving and not receiving home health referrals, respectively (hazard ratio (HR) = 1.52; 95% confidence interval (CI): 1.29-1.80; p < 0.001). Home health referral was also associated with a higher risk of 30-day all-cause mortality (HR = 2.32; 95% CI: 1.58-3.41; p < 0.001) but no...Continue Reading

Citations

Oct 12, 2019·Journal of the American Geriatrics Society·Himali WeerahandiLeora I Horwitz
Feb 7, 2020·Journal of General Internal Medicine·Madeline R SterlingLisa M Kern
Dec 5, 2019·BMJ Quality & Safety·Christine D Jones, Rebecca S Boxer
May 29, 2021·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Salik NazirGeorge V Moukarbel

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