TY - JOUR
T1 - 30-Day Readmission among Elderly Medicare Beneficiaries with Type 2 Diabetes
AU - Raval, Amit D.
AU - Zhou, Steve
AU - Wei, Wenhui
AU - Bhattacharjee, Sandipan
AU - Miao, Raymond
AU - Sambamoorthi, Usha
N1 - Publisher Copyright:
© 2015, Mary Ann Liebert, Inc. 2015.
PY - 2015/8/1
Y1 - 2015/8/1
N2 - This study retrospectively assessed rates and risk factors for all-cause hospital readmission among elderly Medicare beneficiaries with type 2 diabetes mellitus (T2DM) aged ≥65 years. Associations between 30-day readmission and patients' demographic, insurance, index hospital, and clinical characteristics; patient complexities specific to the elderly; and health care utilization were examined using multivariable logistic regressions. Of 202,496 elderly Medicare beneficiaries, 52% were female, 76% were white, the mean age was 75.8 years, and 13.2% had all-cause 30-day readmissions. Elderly patients with cognitive impairment (adjusted odds ratio [aOR]=1.06, 95% confidence interval [CI]=1.01-1.12), falls and falls risk (aOR=1.15, 95% CI=1.08-1.22), polypharmacy (aOR=1.20, 95% CI=1.14-1.27), and urinary incontinence (aOR=1.08, 95% CI=1.01-1.15) were at higher risk for all-cause 30-day readmission than their counterparts without these complexities. As elderly-specific complexities are associated with greater risk for readmission, intervention programs to reduce readmission risk among elderly patients with T2DM should be tailored to suit the needs of elderly patients with extensive complexities.
AB - This study retrospectively assessed rates and risk factors for all-cause hospital readmission among elderly Medicare beneficiaries with type 2 diabetes mellitus (T2DM) aged ≥65 years. Associations between 30-day readmission and patients' demographic, insurance, index hospital, and clinical characteristics; patient complexities specific to the elderly; and health care utilization were examined using multivariable logistic regressions. Of 202,496 elderly Medicare beneficiaries, 52% were female, 76% were white, the mean age was 75.8 years, and 13.2% had all-cause 30-day readmissions. Elderly patients with cognitive impairment (adjusted odds ratio [aOR]=1.06, 95% confidence interval [CI]=1.01-1.12), falls and falls risk (aOR=1.15, 95% CI=1.08-1.22), polypharmacy (aOR=1.20, 95% CI=1.14-1.27), and urinary incontinence (aOR=1.08, 95% CI=1.01-1.15) were at higher risk for all-cause 30-day readmission than their counterparts without these complexities. As elderly-specific complexities are associated with greater risk for readmission, intervention programs to reduce readmission risk among elderly patients with T2DM should be tailored to suit the needs of elderly patients with extensive complexities.
UR - http://www.scopus.com/inward/record.url?scp=84938904211&partnerID=8YFLogxK
U2 - 10.1089/pop.2014.0116
DO - 10.1089/pop.2014.0116
M3 - Article
C2 - 25608114
AN - SCOPUS:84938904211
SN - 1942-7891
VL - 18
SP - 256
EP - 264
JO - Population Health Management
JF - Population Health Management
IS - 4
ER -