scholarly journals Association of Partner Status and Disposition With Rehospitalization in Heart Failure Patients

2012 ◽  
Vol 21 (3) ◽  
pp. e65-e73 ◽  
Author(s):  
Jill Howie-Esquivel ◽  
Joan Gygax Spicer
Keyword(s):  
Heart Failure ◽  
Hospital Readmission ◽  
Older Patients ◽  
Skilled Nursing Facility ◽  
Age Group ◽  
Readmission Rates ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Discharge Disposition ◽  
Patients With Heart Failure

Background Sociodemographic variables that are predictors of rehospitalization for heart failure may better inform hospital discharge strategies. Objectives (1) To determine whether sociodemographic variables are predictors of hospital readmission, (2) to determine whether sociodemographic or laboratory variables differ by age group as predictors of readmission, and (3) to compare whether patients’ discharge disposition differs by age group in predicting readmission. Methods Retrospective chart review of hospitalized patients with heart failure admitted in 2007. Results Mean age was 68 (SD, 17) years for the 809 patients, with slightly more than one-third (n = 311, 38%) reporting a legal partner. Fewer than half (n = 359, 44%) were white. Almost one-third (n = 261, 32%) were rehospitalized within 90 days. Multivariable analysis revealed that patients younger than 65 years old and not partnered were at 1.8 times greater risk for being readmitted 90 days after discharge (P = .02; 95% CI, 0.33–0.92). Patients who were 65 years and older and not partnered were at 2.2 times greater risk for readmission (P = .01; 95% CI, 0.25–0.85) after creatinine level and discharge disposition were controlled for. For older patients discharged to home or to home with home services, the risk of readmission was 2.6 times greater than that for patients discharged to a skilled nursing facility (P = .02; 95% CI, 1.20–5.56). Conclusions The absence of a partner was predictive of readmission in all patients. Older patients with heart failure who were discharged to a skilled nursing facility had lower readmission rates. The effect of partner and disposition status may suggest a proxy for social support. Strategies to provide social support during discharge planning may have an effect on hospital readmission rates.

scholarly journals Skilled Nursing Facility Referral and Hospital Readmission Rates after Heart Failure or Myocardial Infarction

2012 ◽  
Vol 125 (1) ◽  
pp. 100.e1-100.e9 ◽  
Author(s):  
Jersey Chen ◽  
Joseph S. Ross ◽  
Melissa D.A. Carlson ◽  
Zhenqiu Lin ◽  
Sharon-Lise T. Normand ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Hospital Readmission ◽  
Skilled Nursing Facility ◽  
Readmission Rates ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Hospital Readmission Rates

The Association Between Skilled Nursing Facility Care Quality and 30-Day Readmission Rates After Hospitalization for Heart Failure

2014 ◽  
Vol 30 (3) ◽  
pp. 205-213 ◽  
Author(s):  
Owolabi Ogunneye ◽  
Michael B. Rothberg ◽  
Jennifer Friderici ◽  
Mara T. Slawsky ◽  
Vijay T. Gadiraju ◽  
...  
Keyword(s):  
Heart Failure ◽  
Skilled Nursing Facility ◽  
Care Quality ◽  
Readmission Rates ◽  
Nursing Facility ◽  
Skilled Nursing

Disease management partnership with skilled nursing facility improves heart failure 30-day readmission rates

Heart & Lung ◽  
2015 ◽  
Vol 44 (6) ◽  
pp. 556
Author(s):  
Tasha Beck Freitag ◽  
Sandra Young ◽  
Macall Perez ◽  
Dan Altland ◽  
Tamela Sterner
Keyword(s):  
Heart Failure ◽  
Disease Management ◽  
Skilled Nursing Facility ◽  
Readmission Rates ◽  
Nursing Facility ◽  
Skilled Nursing

scholarly journals Reduction in Hospitals’ Readmission Rates: Role of Hospital-Based Skilled Nursing Facilities

2019 ◽  
Vol 56 ◽  
pp. 004695801881799
Author(s):  
Shivani Gupta ◽  
Ferhat D. Zengul ◽  
Ganisher K. Davlyatov ◽  
Robert Weech-Maldonado
Keyword(s):  
Hospital Readmission ◽  
Fixed Effects ◽  
Skilled Nursing Facility ◽  
Health Resources ◽  
Estimating Equation ◽  
Readmission Rates ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
American Hospital ◽  
American Hospital Association

Hospital readmission within 30 days of discharge is an important quality measure given that it represents a potentially preventable adverse outcome. Approximately, 20% of Medicare beneficiaries are readmitted within 30 days of discharge. Many strategies such as the hospital readmission reduction program have been proposed and implemented to reduce readmission rates. Prior research has shown that coordination of care could play a significant role in lowering readmissions. Although having a hospital-based skilled nursing facility (HBSNF) in a hospital could help in improving care for patients needing short-term skilled nursing or rehabilitation services, little is known about HBSNFs’ association with hospitals’ readmission rates. This study seeks to examine the association between HBSNFs and hospitals’ readmission rates. Data sources included 2007-2012 American Hospital Association Annual Survey, Area Health Resources Files, the Centers for Medicare and Medicaid Services (CMS) Medicare cost reports, and CMS Hospital Compare. The dependent variables were 30-day risk-adjusted readmission rates for acute myocardial infarction (AMI), congestive heart failure, and pneumonia. The independent variable was the presence of HBSNF in a hospital (1 = yes, 0 = no). Control variables included organizational and market factors that could affect hospitals’ readmission rates. Data were analyzed using generalized estimating equation (GEE) models with state and year fixed effects and standard errors corrected for clustering of hospitals over time. Propensity score weights were used to control for potential selection bias of hospitals having a skilled nursing facility (SNF). GEE models showed that the presence of HBSNFs was associated with lower readmission rates for AMI and pneumonia. Moreover, higher SNFs to hospitals ratio in the county were associated with lower readmission rates. These findings can inform policy makers and hospital administrators in evaluating HBSNFs as a potential strategy to lower hospitals’ readmission rates.

scholarly journals Discharge to a Skilled Nursing Facility and Subsequent Clinical Outcomes Among Older Patients Hospitalized for Heart Failure

2011 ◽  
Vol 4 (3) ◽  
pp. 293-300 ◽  
Author(s):  
Larry A. Allen ◽  
Adrian F. Hernandez ◽  
Eric D. Peterson ◽  
Lesley H. Curtis ◽  
David Dai ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Outcomes ◽  
Older Patients ◽  
Skilled Nursing Facility ◽  
Nursing Facility ◽  
Skilled Nursing

scholarly journals Developing a Predictive Tool for Hospital Discharge Disposition of Patients Poststroke with 30-Day Readmission Validation

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Jin Cho ◽  
Krystal Place ◽  
Rebecca Salstrand ◽  
Monireh Rahmat ◽  
Misagh Mansouri ◽  
...  
Keyword(s):  
Medicare Beneficiary ◽  
Skilled Nursing Facility ◽  
Risk Scores ◽  
Healthcare Team ◽  
Readmission Rates ◽  
Predictive Tool ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Discharge Disposition ◽  
Complex Decision

After short-term, acute-care hospitalization for stroke, patients may be discharged home or other facilities for continued medical or rehabilitative management. The site of postacute care affects overall mortality and functional outcomes. Determining discharge disposition is a complex decision by the healthcare team. Early prediction of discharge destination can optimize poststroke care and improve outcomes. Previous attempts to predict discharge disposition outcome after stroke have limited clinical validations. In this study, readmission status was used as a measure of the clinical significance and effectiveness of a discharge disposition prediction. Low readmission rates indicate proper and thorough care with appropriate discharge disposition. We used Medicare beneficiary data taken from a subset of base claims in the years of 2014 and 2015 in our analyses. A predictive tool was created to determine discharge disposition based on risk scores derived from the coefficients of multivariable logistic regression related to an adjusted odds ratio. The top five risk scores were admission from a skilled nursing facility, acute heart attack, intracerebral hemorrhage, admission from “other” source, and an age of 75 or older. Validation of the predictive tool was accomplished using the readmission rates. A 75% probability for facility discharge corresponded with a risk score of greater than 9. The prediction was then compared to actual discharge disposition. Each cohort was further analyzed to determine how many readmissions occurred in each group. Of the actual home discharges, 95.7% were predicted to be there. However, only 47.8% of predictions for home discharge were actually discharged home. Predicted discharge to facility had 15.9% match to the actual facility discharge. The scenario of actual discharge home and predicted discharge to facility showed that 186 patients were readmitted. Following the algorithm in this scenario would have recommended continued medical management of these patients, potentially preventing these readmissions.

scholarly journals Does geriatric follow-up visits reduce hospital readmission among older patients discharged to temporary care at a skilled nursing facility: a before-and-after cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e046698
Author(s):  
Katja Thomsen ◽  
Anders Fournaise ◽  
Lars Erik Matzen ◽  
Karen Andersen-Ranberg ◽  
Jesper Ryg
Keyword(s):  
Cohort Study ◽  
Hospital Readmission ◽  
Older Patients ◽  
Skilled Nursing Facility ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Hospitalised Patients ◽  
Before And After ◽  
Geriatric Team

IntroductionHospital readmission is a burden to patients, relatives and society. Older patients with frailty are at highest risk of readmission and its negative outcomes.ObjectiveWe aimed at examining whether follow-up visits by an outgoing multidisciplinary geriatric team (OGT) reduces unplanned hospital readmission in patients discharged to a skilled nursing facility (SNF).DesignA retrospective single-centre before-and-after cohort study.Setting and participantsStudy population included all hospitalised patients discharged from a Danish geriatric department to an SNF during 1 January 2016–25 February 2020. To address potential changes in discharge and readmission patterns during the study period, patients discharged from the same geriatric department to own home were also assessed.InterventionOGT visits at SNF within 7 days following discharge. Patients discharged to SNF before 12 March 2018 did not receive OGT (−OGT). Patients discharged to SNF on or after 12 March 2018 received the intervention (+OGT).Main outcome measuresUnplanned hospital readmission between 4 hours and 30 days following initial discharge.ResultsTotally 847 patients were included (440 −OGT; 407 +OGT). No differences were seen between the two groups regarding age, sex, activities of daily living (ADLs), Charlson Comorbidity Index (CCI) or 30-day mortality. The cumulative incidence of readmission was 39.8% (95% CI 35.2% to 44.8%, n=162) in −OGT and 30.2% (95% CI 25.8% to 35.2%, n=113) in +OGT. The unadjusted risk (HR (95% CI)) of readmission was 0.68 (0.54 to 0.87, p=0.002) in +OGT compared with –OGT, and remained significantly lower (0.72 (0.57 to 0.93, p=0.011)) adjusting for age, length of stay, sex, ADL and CCI. For patients discharged to own home the risk of readmission remained unchanged during the study period.ConclusionFollow-up visits by OGT to patients discharged to temporary care at an SNF significantly reduced 30-day readmission in older patients.

scholarly journals Skilled Nursing Facility Care for Patients With Heart Failure: Can We Make It “Heart Failure Ready?”

2016 ◽  
Vol 22 (12) ◽  
pp. 1004-1014 ◽  
Author(s):  
Nicole M. Orr ◽  
Rebecca S. Boxer ◽  
Mary A. Dolansky ◽  
Larry A. Allen ◽  
Daniel E. Forman
Keyword(s):  
Heart Failure ◽  
Skilled Nursing Facility ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Patients With Heart Failure
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