Function and Caregiver Support Associated With Readmissions During Home Health for Individuals With Dementia.
Sara Knox, Brian Downer, Allen Haas and 2 others
PMID 32035139WHAT IT FOUND
In home health for dementia, patients most dependent in mobility and self-care were more likely to be readmitted within 30 days.
Cognitive and caregiver support deficits also tracked with readmission, but mobility and self-care links remained after adjustment.
Key findings
01The overall 30-day potentially preventable readmission rate was 7.6%.
02The most dependent mobility and self-care groups had adjusted odds of readmission 1.68 and 1.78 times those of the most independent groups.
03Unmet caregiver needs were associated with adjusted odds of readmission 1.20 times those of met caregiver needs, and the cognitive association became 1.00 and was no longer significant after self-care adjustment.
STILL TO COME
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What it does not show
This was an observational analysis of administrative records, so it can show association but not prove that any factor caused readmission. Cognitive status came from OASIS items and a dementia diagnosis from ICD-9 codes, not an objective cognitive test. The dementia diagnosis definition has poor sensitivity, and some patients labeled dementia scored as having minimal to no cognitive deficits. Cognitive impairment was dichotomized, so the study could not distinguish stages of dementia. Caregiver support was measured only at admission, so it could not capture changes in support during the home health episode.
Declared interests
The paper is tagged as supported by NIH extramural and non-U.S. government research support. The supplied text does not state additional author conflicts.
The easy way to misread this
Do not conclude that treating mobility, self-care, caregiver support, or cognition will reduce readmissions. This study observed associations at home health admission and did not test any intervention.