Patient and health system factors associated with hospital readmission in older adults without cognitive impairment.

TitlePatient and health system factors associated with hospital readmission in older adults without cognitive impairment.
Publication TypeJournal Article
Year of Publication2018
AuthorsVasiliadis H-M, Milan R, Guerra SGontijo, MJ Fleury
JournalGen Hosp Psychiatry
Volume53
Pagination44-51
Date Published2018 Jul - Aug
ISSN1873-7714
KeywordsAged, Aged, 80 and over, Comorbidity, Female, Follow-Up Studies, Health Status, Humans, Male, Mental Disorders, Patient Readmission, Quebec
Abstract

OBJECTIVE: To study the factors associated with hospital readmission.METHODS: Data used in this study came from a population-based survey of older adults without cognitive impairment. Cox regression was used to assess the factors associated with readmission within a 2-year follow-up period. According to Andersen's model of healthcare seeking behavior, study variables considered included predisposing, enabling and need factors at the individual and health system levels.RESULTS: Of the 433 participants with an index hospitalization, 97% were discharged with a physical and 3% with a psychiatric disorder. During follow-up, 29% (128/433) were readmitted with a median time to readmission reaching 83 days. The risk of readmission was associated with the following: age, marital status, attraction index of the region of residence for psychiatric services, the presence of an anxio-depressive and other mental disorder, as well as a disorder of the musculoskeletal system. The presence of a physical and psychiatric comorbidity was also associated with readmission.CONCLUSIONS: Post-discharge follow-up of vulnerable populations with a history of mental disorders and improved availability of psychiatric services in the community are associated with a reduced risk of readmission.

DOI10.1016/j.genhosppsych.2018.05.003
Alternate JournalGen Hosp Psychiatry
PubMed ID29804009
Grant List200683MOP / / CIHR / Canada