Risk Factors for All-Cause Rehospitalization Among Medicare Recipients with Heart Failure Receiving Telehomecare

Abstract

The risk factors identified from this study may be used to drive more effective telehomecare placements, and referrals for additional services among telehomecare patients with HF.

The Prevalence, Reasons, and Risk Factors for Hospital Readmissions Among Home Health Care Patients: A Systematic Review

“…In a study of 526 HF patients receiving telehomecare, the researchers identified that 80% of the hospital readmissions could be accounted for by the following five reasons: HF, other heart disease, respiratory infection, cardiac dysrhythmia, and other respiratory problem. 23 Similarly, Thomason et al reported that four out of the seven hospital readmissions, or 57%, among 70 HF patients receiving telehomecare, were due to exacerbation of HF symptoms. 24 Three studies by Madigan and colleagues further shed light on diagnostic reasons for hospital readmissions among HF patients.…”

“…Half (n = 9) of the reviewed studies focused on patients with heart failure (HF). Of these studies, there were six on HF patients receiving regular home care, [16][17][18][19][20][21] two on HF patients receiving telehomecare, 22,23 and one study on HF patients receiving either regular home care or telehomecare. 24 The other studies covered a variety of HHC patients with seven (39%) focused on general home care patients, [25][26][27][28][29][30][31] one (6%) focused on patient with diabetes, 32 and one (6%) focused on children.…”

“…24 The other studies covered a variety of HHC patients with seven (39%) focused on general home care patients, [25][26][27][28][29][30][31] one (6%) focused on patient with diabetes, 32 and one (6%) focused on children. 33 Twelve studies (67%) were conducted within a single HHC agency 20,[22][23][24][28][29][30][31]33 or included patients discharged from a single hospital (n = 3). 17,21,27 The other six (33%) were multisite studies, including those using national representative samples (n = 4).…”

“…18 Reported 60-day readmission rates ranged from 19% to 36%. 22,23,30 One study reported a 90-day readmission rate of 34% in HF patients. 20 In two studies, researchers reported 14-week hospital readmission rates as 35% 17 and 42% 21 among HF patients, respectively.…”

“…Of the six studies that reported reasons for hospital readmissions, five focused on HF patients 16,18,19,23,24 and one on general HHC patients. 25 For those studies focusing on HF patients, cardiac-related diagnosis and respiratory problems were reported as the most common reasons for hospital readmissions.…”