AbstractsMedical & Health Science

Patient characteristics related to hospital readmission in heart failure patients

by Cheng-hui Chou

Institution: Case Western Reserve University
Department: Nursing
Degree: PhD
Year: 2009
Keywords: Nursing; Heart failure; readmisson; patient characteristics
Record ID: 1854365
Full text PDF: http://rave.ohiolink.edu/etdc/view?acc_num=case1220463022


The unplanned hospital readmissions in elderly with heart failure consume a considerable amount of healthcare and social resources. Thus, knowledge of the characteristics and predictive factors for patients who are at high risk for hospital readmission could provide a better understanding upon which to develop effective interventions aimed at improving patient outcomes in heart failure patients. The purpose of this study was to examine the patient characteristics and factors related to hospital readmission in heart failure patients. Multivariate analyses of 98heart failure patients treated and discharged during May 1, 2006 to May, 1, 2007 were performed. Andersen's Behavioral Model of Health Service Utilization was used to organize factors including population characteristics (predisposing characteristics, enabling resources, and need), health behaviors/use of health services (hospital length of stay, home healthcare, CCU stay, device implantation), and outcome (readmission). Differences in population characteristics between readmitted and not readmitted patients were compared. Readmitted study patients had a significantly lower hemoglobin (t = 2.23, p = .03) and significantly higher sodium level (t = -2.3, p = .02). In addition,, patients who were diagnosed with diabetes (¿2 = 4.4, p = .04) or who had physical impairment at discharge (¿2 = 9.2, p = .002) had higher readmission rate than the not readmitted HF patients. Use of health services was compared. The readmitted HF patients were more likely to have a CCU stay at their index admission (26% vs. 9%). There were not significant differences on hospital length of stay, having device implantation, and home healthcare between readmitted and not readmitted patients. A lower LVEF, the presence of physical impairment were associated with longer hospital stays. Heart failure patients with physical impairment and those with diabetes were more likely to received home healthcare before their initial hospitalization. Conclusion: Population characteristic of HF patients were influential on hospital readmission. Among three of the sub-concepts of population characteristics, need had the most predictability in this study, consistent with the theory. However, the moderating effect of use of health service between population characteristics and outcome was not supported in this study.