Risk predictors for hospital readmission in a low socio-economic and underserved population

Abstract

Objective: Hospital readmissions are significant and potentially preventable sources of healthcare cost in the United States. The Affordable Care Act (ACA) establishes the Hospital Readmissions Reduction Program (HRRP) in an attempt to reduce readmissions by penalizing institutions whose 30-day readmission rates are above the national average. The current study examines demographic and clinical variables associated with early hospital readmission in a low socioeconomic status, underserved population. Methods: A secondary data analysis was conducted of 2,536 patients from the acute primary care facilities who were hospitalized. Age, sex, race, ethnicity, smoking status, systolic blood pressure, diastolic blood pressure, body temperature, pulse rate, and days to follow up visit were analyzed in a sample of 2,536 hospitalized patients at or below 200% of federal poverty guidelines in Central Texas to determine association with risk of 0-30-(30), 31-60-(60) and 61-90-(90) day all-cause readmission. Results: Multinomial statistical analysis found pulse rate was associated with 30-, 60-, and 90-day readmission as compared to a control group. Days to follow-up were associated with decreased risk of readmission in all groups, and passive smoking status was associated with decreased risk of 90-day readmission as compared to a control group. Conclusions: Results offer healthcare providers with tools for potentially identifying patients at elevated risk for readmission in a disadvantaged population and suggest further investigation of other clinical and laboratory variables as predictors of readmission risk.