Predictors of Rehospitalization in Post-Acute Rehabilitation among Different Ethnic Groups.
Verena R Cimarolli, Francesca Falzarano, Stephanie Hicks
PMID 31759902WHAT IT FOUND
Rehospitalization during post-acute rehab was linked to different factors by ethnicity: better community quality for Hispanics; ADL dependence, shorter stay, and lack of support for African Americans; shorter stay, lack of support, depressive symptoms, lower cognition, and being male for whites.
Key findings
01In Hispanic patients, higher community quality was associated with a 57% reduction in the likelihood of rehospitalization for each unit increase in the community quality score.
02In African American patients, higher admission ADL dependence and shorter length of stay were associated with higher rehospitalization likelihood, while having social support was associated with an 85% lower likelihood.
03In white patients, women were 61% less likely than men to be rehospitalized, and those with social support were 70% less likely than those without; lower admission cognitive functioning, higher admission depressive symptoms, and shorter length of stay were also associated with higher likelihood.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The supplied text does not state how many patients were analysed, so the size of the evidence is unclear. It was done at a single skilled nursing facility in New York City, so it may not apply to other places or patients. It only looked at older adults admitted with cardiovascular disease and only compared Hispanic, African American, and white patients. The study used MDS assessments completed by clinicians, which may not be standardised and may have scoring problems. Individual socioeconomic status and income were not in the medical records, so community census data were used as a proxy. Quality of post-acute care received was not measured, even though it can affect outcomes. The design is observational and cannot show that any factor caused rehospitalization or that changing it would prevent rehospitalization.
Declared interests
The authors declared no conflicts of interest. No funding source is reported in the supplied text.
The easy way to misread this
Do not read the 57%, 85%, and 70% reductions as proof that improving community quality, social support, or discharge planning prevents rehospitalization. These were associations from a single observational chart review, and the study did not test any intervention.