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Coronavirus Disease 2019 and Hospital Readmissions: Patient Characteristics and Socioeconomic Factors Associated With Readmissions in an Urban Safety-Net Hospital System.
Gore, Victoria; Li, Zeyu; Drake, Carolyn B; Heath, Jacqueline L; Raiszadeh, Farbod; Daniel, Jean; Fagan, Ian.
  • Gore V; Department of Medicine, New York University Grossman School of Medicine and Bellevue Hospital Center.
  • Li Z; Office of Ambulatory Care and Population Health, NYC Health + Hospitals.
  • Drake CB; Department of Medicine, New York University Grossman School of Medicine and Bellevue Hospital Center.
  • Heath JL; Department of Medicine, New York University Grossman School of Medicine and Bellevue Hospital Center.
  • Raiszadeh F; Division of Cardiology, Department of Medicine, Harlem Hospital Center, Columbia University College of Physicians and Surgeons, New York.
  • Daniel J; Department of Medicine, Lincoln Hospital, Bronx, NY.
  • Fagan I; Department of Medicine, New York University Grossman School of Medicine and Bellevue Hospital Center.
Med Care ; 60(2): 125-132, 2022 02 01.
Article in English | MEDLINE | ID: covidwho-1874054
ABSTRACT

BACKGROUND:

It is not yet known whether socioeconomic factors (ie, social determinants of health) are associated with readmission following hospitalization for coronavirus disease 2019 (COVID-19).

METHODS:

We conducted a retrospective cohort study of 6191 adult patients hospitalized with COVID-19 in a large New York City safety-net hospital system between March 1 and June 1, 2020. Associations between 30-day readmission and selected demographic characteristics, socioeconomic factors, prior health care utilization, and relevant features of the index hospitalization were analyzed using a multivariable generalized estimating equation model.

RESULTS:

The readmission rate was 7.3%, with a median of 7 days between discharge and readmission. The following were risk factors for readmission age 65 and older [adjusted odds ratio (aOR) 1.32; 95% confidence interval (CI) 1.13-1.55], history of homelessness, (aOR 2.03 95% CI 1.49-2.77), baseline coronary artery disease (aOR 1.68; 95% CI 1.34-2.10), congestive heart failure (aOR 1.34; 95% CI 1.20-1.49), cancer (aOR 1.68; 95% CI 1.26-2.24), chronic kidney disease (aOR 1.74; 95% CI 1.46-2.07). Patients' sex, race/ethnicity, insurance, and presence of obesity were not associated with increased odds of readmission. A longer length of stay (aOR 0.98; 95% CI 0.97-1.00) and use of noninvasive supplemental oxygen (aOR 0.68; 95% CI 0.56-0.83) was associated with lower odds of readmission. Upon readmission, 18.4% of patients required intensive care, and 13.7% expired.

CONCLUSION:

We have found some factors associated with increased odds of readmission among patients hospitalized with COVID-19. Awareness of these risk factors, including patients' social determinants of health, may ultimately help to reduce readmission rates.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Readmission / Safety-net Providers / COVID-19 / Hospitalization Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Med Care Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Readmission / Safety-net Providers / COVID-19 / Hospitalization Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Med Care Year: 2022 Document Type: Article