What makes a patient more likely to end up back in the hospital? Study finds surprising role for social factors

From the article on Science Daily:

No patient who just got out of the hospital wants to end up there again soon. Whoever’s paying their hospital bills doesn’t want that either.

That’s why the Medicare system has started penalizing hospitals with the highest readmission rates for certain conditions. But a new study suggests that unlike hospital gowns, such penalties should not be one-size-fits-all.

In fact, the study shows, certain social, economic, disability and personal-care factors can make a major difference in the readmission risk of people who were recently hospitalized for heart failure, pneumonia or a heart attack.

And the factors that make the most difference vary greatly from condition to condition, and are largely not something a hospital can change through treatment.

For instance, pneumonia patients who already had trouble with multiple tasks like getting dressed or cooking food, or who needed paid help at home, before their hospital stay were the most likely of all pneumonia patients to be readmitted in the first 30 days after a hospitalization, the study shows.

But for patients with heart failure, that kind of functional difficulty didn’t matter as much as money, family and race. Those who had a higher wealth level or adult children had a much lower chance of readmission — while simply being African American increased the risk of another hospital stay.

And for heart attack survivors, the most important factors boosting their chance of readmission were whether they had been in a nursing home before their hospital stay, and whether their hospital cared for a high percentage of minority patients.

The results, published in the Journal of General Internal Medicine, come from a team from the University of Michigan Medical School and Institute for Healthcare Policy and Innovation, and the VA Ann Arbor Healthcare System. They used data from the Health and Retirement Study, based at the U-M Institute for Social Research, and from Medicare, and looked at 10 measures of disability and what are called “social determinants of health.”

Read the full article.