Coronavirus Disease 2019 and Hospital Readmissions: Patient Characteristics and Socioeconomic Factors Associated With Readmissions in an Urban Safety-Net Hospital System.
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.
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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