Postdischarge environmental and socioeconomic factors and the likelihood of early hospital readmission among community-dwelling Medicare beneficiaries

The Gerontologist
Alicia I ArbajeChad Boult

Abstract

This study attempts to determine the associations between postdischarge environmental (PDE) and socioeconomic (SES) factors and early readmission to hospitals. This study was a cohort study using the 2001 Medicare Current Beneficiary Survey and Medicare claims for the period from 2001 to 2002. The participants were community-dwelling Medicare beneficiaries admitted to hospitals, discharged home, and surviving at least 1 year after discharge (n = 1,351). The study measurements were early readmission (within 60 days), PDE factors, and SES factors. PDE factors consisted of having a usual source of care, requiring assistance to see the usual source of care, marital status, living alone, lacking self-management skills, having unmet functional need, having no helpers with activities of daily living, number of living children, and number of levels in the home. SES factors consisted of education, income, and Medicaid enrollment. Of the 1,351 beneficiaries, 202 (15.0%) experienced an early readmission. After adjustment for demographics, health, and functional status, the odds of early readmission were increased by living alone (odds ratio or OR = 1.50, 95% confidence interval or CI = 1.01-2.24), having unmet functional need (OR = 1.48, ...Continue Reading

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