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  • Title: Association of partner status and disposition with rehospitalization in heart failure patients.
    Author: Howie-Esquivel J, Spicer JG.
    Journal: Am J Crit Care; 2012 May; 21(3):e65-73. PubMed ID: 22549582.
    Abstract:
    BACKGROUND: Sociodemographic variables that are predictors of rehospitalization for heart failure may better inform hospital discharge strategies. OBJECTIVES: (1) To determine whether sociodemographic variables are predictors of hospital readmission, (2) to determine whether sociodemographic or laboratory variables differ by age group as predictors of readmission, and (3) to compare whether patients' discharge disposition differs by age group in predicting readmission. METHODS: Retrospective chart review of hospitalized patients with heart failure admitted in 2007. RESULTS: Mean age was 68 (SD, 17) years for the 809 patients, with slightly more than one-third (n = 311, 38%) reporting a legal partner. Fewer than half (n = 359, 44%) were white. Almost one-third (n = 261, 32%) were rehospitalized within 90 days. Multivariable analysis revealed that patients younger than 65 years old and not partnered were at 1.8 times greater risk for being readmitted 90 days after discharge (P = .02; 95% CI, 0.33-0.92). Patients who were 65 years and older and not partnered were at 2.2 times greater risk for readmission (P = .01; 95% CI, 0.25-0.85) after creatinine level and discharge disposition were controlled for. For older patients discharged to home or to home with home services, the risk of readmission was 2.6 times greater than that for patients discharged to a skilled nursing facility (P = .02; 95% CI, 1.20-5.56). CONCLUSIONS: The absence of a partner was predictive of readmission in all patients. Older patients with heart failure who were discharged to a skilled nursing facility had lower readmission rates. The effect of partner and disposition status may suggest a proxy for social support. Strategies to provide social support during discharge planning may have an effect on hospital readmission rates.
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