What is the clinical evidence from this study?

Study design: Cohort. Population: Hospital admission (n=29292). Intervention: Risk factors. Primary outcome: 30-day hospital readmission (RR 1.94, 95% CI 1.80-2.09).

What does this research mean for the field?

Discharge to long-term care has the highest population-attributable risk for 30-day hospital readmission among adults aged 65 and older. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To develop and validate risk prediction models for 30-day hospital readmission among older adults using administrative data and alternate comorbidity indices.

October 1, 2008Baylor University Medical Center ProceedingsOpen Access

Risk Factors for 30-Day Hospital Readmission in Patients ≥65 Years of Age

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Key result

Discharge to long-term care had the highest population-attributable risk for 30-day hospital readmission among adults ≥65 years (RR 1.94; 95% CI 1.80-2.09).

Population

29,292 adults aged 65 or older admitted from July 2002 to June 2004 to any of seven acute care hospitals in…

Design

Cohort

Follow-up

30-day

Authors

MSMarc D. SilversteinVascular Medicine HQHuanying QinInstitute for Women's Policy Research SMSandra MercerSouthern Illinois University School of Medicine

Discussion

Member takes

Implication

May aid early identification of high-risk older adults via administrative data; leaves open whether targeted interventions reduce readmissions.

Key Points

To develop and validate risk prediction models for 30-day hospital readmission among older adults using administrative data and alternate comorbidity indices.
Conducted a retrospective cohort study of N = 29,292 adults aged ≥65 admitted to seven acute care hospitals between July 2002 and June 2004.
Developed models in a two-thirds random derivation sample and validated them in the remaining one-third sample, comparing the Elixhauser classification and the High-Risk Diagnoses in the Elderly Scale alongside demographic and health system variables.
Discharge to a long-term care facility demonstrated the highest population-attributable risk for 30-day readmission at 12.86% (RR 1.94, 95% CI 1.80–2.09).
Multivariable models demonstrated modest discrimination (C statistic 0.65) and acceptable calibration (Hosmer-Lemeshow χ² = 6.08, P > 0.24), identifying age ≥75, male sex, African American race, medical service admission, and Medicare-only coverage as key risk factors.

Study Design

Type

Cohort (n=29,292)

Multicenter

Yes

Structured PICO

Population

29,292 adults aged 65 or older admitted from July 2002 to June 2004 to any of seven acute care hospitals in the Dallas-Fort Worth metropolitan area affiliated with the Baylor Health Care System

Outcome

30-day hospital readmissionhard clinical

Main Result

Effect estimate: RR 1.94 (95% CI 1.80-2.09)

Readily available administrative data, including discharge location and comorbidities, can identify older adults at high risk for 30-day hospital readmission early in their hospital course.

Cite This Study

Silverstein et al. (2008) conducted a cohort in Hospital admission (n=29,292). Risk factors was evaluated on 30-day hospital readmission (RR 1.94, 95% CI 1.80-2.09). Discharge to long-term care had the highest population-attributable risk for 30-day hospital readmission among adults ≥65 years (RR 1.94; 95% CI 1.80-2.09).

synapsesocial.com/papers/6a155b0a79ff98d0de4e7f89 https://doi.org/10.1080/08998280.2008.11928429

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Implication

May aid early identification of high-risk older adults via administrative data; leaves open whether targeted interventions reduce readmissions.

Risk Factors for 30-Day Hospital Readmission in Patients ≥65 Years of Age

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Risk Factors for 30-Day Hospital Readmission in Patients ≥65 Years of Age

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider