Dementia Severity Associated With Increased Risk of Potentially Preventable Readmissions During Home Health Care.
Sara Knox, Brian Downer, Allen Haas and 2 others
PMID 31734120WHAT IT FOUND
Home health patients in the two most severe dementia categories had 30-day potentially preventable readmission rates of 12.6% and 8.8%, at the top of the 5.6% to 12.6% range.
The overall rate was 7.6%.
Key findings
01Patients in dementia severity categories 6 and 7 had significantly higher odds of 30-day potentially preventable readmission than category 2 (OR 1.37 and 1.94).
02Patients in dementia severity categories 3, 4, and 5 did not have significantly different odds of 30-day potentially preventable readmission compared with category 2 (OR 0.95, 0.99, and 1.06).
03Patients with 4 or more acute hospital stays in the prior year had a 30-day potentially preventable readmission rate of 25.2%, compared with 2.5% for patients with no other acute stays.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study had no gold standard for dementia severity, so the OASIS-based FAST categories may not accurately classify each patient. OASIS administration can vary between home health agencies and clinicians, which may affect severity category assignment. The analysis did not control for housing conditions, social support, and other social determinants that may affect readmission. It did not include people with dementia discharged to settings other than home health, so it cannot say how readmission risk compares across discharge settings. Few patients were in some categories, including less than 2% in the most severe category, so those estimates rest on fewer patients.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that severe dementia caused readmission or that a home health programme can lower the rate based on this paper. It is an observational association, and it did not test any treatment.