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Discharge destination and repeat hospitalizations

L C Camberg1, N E Smith, M Beaudet

  • 1Health Services Research and Development, Brockton/West Roxbury VA Medical Center, MA 02132, USA.

Medical Care
|August 1, 1997
PubMed
Summary
This summary is machine-generated.

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Discharge destination impacts hospital readmissions. Patients with chronic obstructive pulmonary disease or dementia discharged to nursing homes had fewer 30-day readmissions than those discharged home.

Area of Science:

  • Geriatric Medicine
  • Health Services Research
  • Public Health

Background:

  • Hospital readmissions pose significant challenges to healthcare systems.
  • Discharge destination's role in readmission rates remains unclear.
  • Understanding this relationship is crucial for effective patient care and resource allocation.

Purpose of the Study:

  • To determine if discharge destination influences hospital readmission rates.
  • To analyze the impact of nursing home versus personal home discharge on repeat hospitalizations.
  • To examine this association within a national sample of Veterans Health Administration (VHA) patients.

Main Methods:

  • A 20% random sample of VHA patients aged 65+ with COPD, stroke, or dementia discharged in 1988 was analyzed.

Related Experiment Videos

  • Discharge destination (personal home vs. nursing home) was determined using multiple administrative data sources.
  • Proportional hazards regression models assessed the association between discharge destination and readmission within 30 days, 6 months, 1 year, and 2 years, adjusting for covariates.

    • Main Results:

    • Patients with chronic obstructive pulmonary disease (COPD) discharged to nursing homes were less likely to be readmitted within 30 days compared to those discharged home.
    • Patients with dementia discharged to nursing homes also showed a reduced likelihood of 30-day readmission compared to those discharged home.
    • These findings held after adjusting for patient characteristics and including out-of-system (Medicare) use.

    Conclusions:

    • Discharge destination is a significant factor influencing hospital readmission rates.
    • Nursing home discharges may be associated with lower short-term readmission rates for specific patient groups (COPD, dementia).
    • Findings support refining hospital performance metrics and targeting interventions to reduce readmissions and associated costs.