Care setting and 30-day hospital readmissions among older adults: a population-based cohort study.

Care setting and 30-day hospital readmissions among older adults: a population-based cohort study. CMAJ. 2018 Sep 24;190(38):E1124-E1133 Authors: Gruneir A, Fung K, Fischer HD, Bronskill SE, Panjwani D, Bell CM, Dhalla I, Rochon PA, Anderson G Abstract BACKGROUND: Despite the fact that many older adults receive home or long-term care services, the effect of these care settings on hospital readmission is often overlooked. Efforts to reduce hospital readmissions, including capacity planning and targeting of interventions, require clear data on the frequency of and risk factors for readmission among different populations of older adults. METHODS: We identified all adults older than 65 years discharged from an unplanned medical hospital stay in Ontario between April 2008 and December 2015. We defined 2 preadmission care settings (community, long-term care) and 3 discharge care settings (community, home care, long-term care) and used multinomial regression to estimate associations with 30-day readmission (and death as a competing risk). RESULTS: We identified 701 527 individuals (mean age 78.4 yr), of whom 414 302 (59.1%) started in and returned to the community. Overall, 88 305 in dividuals (12.6%) were re admitted within 30 days, but this proportion varied by care setting combination. Relative to individuals returning to the community, those discharged to the community with home care (adjusted odds ratio [OR] 1.43, 95% c...
Source: cmaj - Category: General Medicine Authors: Tags: CMAJ Source Type: research