Factors predicting readmission of older general medicine patients.

摘要: Objectives:1) Identify demographic, clinical, social support, functional, and psychological factors about which data are available within 24 hours of hospital admission associated with emergent unscheduled readmission for a group older general medicine patients; 2) develop model to predict readmission. Design:Interview- cbart-based study admissions that occurred 60 days discharge. Setting:General wards the Memphis Veterans Affairs Medical Center, an 862-bed university-affiliated tertiary care facility. Patients/participants:General patients ≥ 65 years old (n=173). Inclusion criteria were willingness participate, written consent (patient or family member), patient interview 36 admission. Measurements main results:The dependent variable was discharge from hospital. Independent variables included demographic (age, race, income, education), support (marital status, living arrangements), (cognition, depression), activities daily functioning, clinical (diagnoses, type source admission, length stay, numbers hospitalizations in past year, illness severity) parameters. Readmitted emergently admitted more severely ill, had diagnoses chronic obstructive pulmonary disease (COPD) congestive heart failure (CHF), less ischemic disease, year (all p<0.05). Logistic regression identified diagnostic (COPD CHF), severity as predictive The likelihood being readmitted 5.4. Accuracy three-variable 76%, predicted value positive, 73%, negative, 77%. Conclusions:Chronically ill who at index have several tend be readmitted. Using this model, high-risk may prospectively targeted reduce readmissions.