Function and Caregiver Support Associated With Readmissions During Home Health for Individuals With Dementia.
Arch Phys Med Rehabil
; 101(6): 1009-1016, 2020 06.
Article
en En
| MEDLINE
| ID: mdl-32035139
ABSTRACT
OBJECTIVE:
The purpose of this study was to determine the association between mobility, self-care, cognition, and caregiver support and 30-day potentially preventable readmissions (PPR) for individuals with dementia.DESIGN:
This retrospective study derived data from 100% national Centers for Medicare and Medicaid Services data files from July 1, 2013, through June 1, 2015.PARTICIPANTS:
Criteria from the Home Health Claims-Based Rehospitalization Measure and the Potentially Preventable 30-Day Post Discharge Readmission Measure for the Home Health Quality Reporting Program were used to identify a cohort of 118,171 Medicare beneficiaries. MAIN OUTCOMEMEASURE:
The 30-day PPR rates with associated 95% CIs were calculated for each patient characteristic. Multilevel logistic regression was used to study the relationship between mobility, self-care, caregiver support, and cognition domains and 30-day PPR during home health, adjusting for patient demographics and clinical characteristics.RESULTS:
The overall rate of 30-day PPR was 7.6%. In the fully adjusted models, patients who were most dependent in mobility (odds ratio [OR], 1.59; 95% CI, 1.47-1.71) and self-care (OR, 1.73; 95% CI, 1.61-1.87) had higher odds for 30-day PPR. Patients with unmet caregiving needs had 1.11 (95% CI, 1.05-1.17) higher odds for 30-day PPR than patients whose caregiving needs were met. Patients with cognitive impairment had 1.23 (95% CI, 1.16-1.30) higher odds of readmission than those with minimal to no cognitive impairment.CONCLUSIONS:
Decreased independence in mobility and self-care tasks, unmet caregiver needs, and impaired cognitive processing at admission to home health are associated with risk of 30-day PPR during home health for individuals with dementia. Our findings indicate that deficits in mobility and self-care tasks have the greatest effect on the risk for PPR.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Readmisión del Paciente
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Cuidadores
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Demencia
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Servicios de Atención de Salud a Domicilio
Tipo de estudio:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Límite:
Aged
/
Aged80
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Female
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Humans
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Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Arch Phys Med Rehabil
Año:
2020
Tipo del documento:
Article