151. The Impact of Personal and Historical Factors That Contribute to Medicare Readmissions.
- Author
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Krause, Trudy Millard, Hamden, Randa, and Schaefer, Caroline M.
- Subjects
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FEE for service (Medical fees) , *SOCIAL determinants of health , *HOSPITAL emergency services , *CONFIDENCE intervals , *PATIENT readmissions , *RACE , *RISK assessment , *COMPARATIVE studies , *HEALTH insurance reimbursement , *SEX distribution , *MEDICAL history taking , *DESCRIPTIVE statistics , *SOCIODEMOGRAPHIC factors , *PEOPLE with disabilities , *PATIENT compliance , *DATA analysis software , *ODDS ratio , *MEDICARE - Abstract
Medicare readmissions from the 5% national sample of Medicare Fee For Service claims were assessed to identify the contribution of various demographic or personal health history risk factors to the liklihood of readmission within 30 days of discharge. The Medicare population was evaluated as 2 cohorts based on their eligibility status: age (71.9%) or disability (18.1%). Roughly 12% of admissions for the aged population resulted in a readmission within 30 days, whereas ∼18% was true of the disabled population. Patients with a history of frequent emergency department visits or an urgent index admission had an increased risk for a readmission in both groups of beneficiaries. An important indicator for readmission risk was discharge status from the index hospital stay. In both categories of beneficiaries, individuals who were discharged against medical advice were 1.6 times more likely to experience a readmission. Most importantly, personal and social determinants of health (SDOH) documented preadmission and postdischarge were more evident for the disabled population than the aged. Furthermore, when pre- and postadmission spans for SDOH conditions were examined, (6 months before initial admission to 30 days postadmission), both the aged and disabled populations were statistically significantly more likely to experience readmissions if they had an SDOH diagnosis. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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