An Exploration of Heart Failure Readmission in Eastern North Carolina

Abstract

The purpose of this study is to identify and associate the level of patient activation and presence of comorbidities with early readmission, hospital discharge disposition, length of stay, number of admissions and all-cause death in adults hospitalized for heart failure during the years of 2012- 2014. To clarify these associations, the total heart failure admission sample will be further defined by gender, race, age and type of admitting hospital (tertiary or community). Specifically, this study seeks to explore readmission and comorbidity patterns that may be associated with levels of patient activation, discharge disposition and personal characteristic variables related to early readmission within the heart failure population of Eastern North Carolina. This was a non-experimental, retrospective cohort study designed to explore readmission patterns that may be associated with levels of patient activation, discharge disposition and characteristic variables related to early readmission within the heart failure population of Eastern North Carolina. Findings from this study included a 24% 30-day readmission rate among heart failure patients between 2012 and 2014. Within this patient population, strong associations (p [less than] .0001) were found between race/gender pairings and age, smoking status, payer source, discharge disposition, marital status and all-cause death during inpatient hospitalization. Associations were found between patient activation and age, payer source, initial discharge disposition and initial hospital type. In addition, significant associations were found between 30-day readmission status and all-cause hospital death (p [less than] .0001). Comorbidities and comorbidity clusters within a primary diagnosis of heart failure were evaluated. Significant associations were found within comorbidity clusters and hospital type (medical center versus community hospital) (p [less than] .0001). This study represents new insights to the assessment and care of heart failure patients in Eastern North Carolina, and the unique needs related to discharge and the continuum of care to reduce readmission risk.