Impact of disability and social determinants on readmissions

Editor's Note

Disability and social determinants of health influence readmission risk differently when added to the Medicare risk adjustment models for the three conditions Medicare focuses on for hospital payment, finds this study.

Pneumonia patients who already had difficulties with activities of daily living (ADL) before admission were more likely to be readmitted within 30 days of discharge.

For heart failure patients, ADL didn’t matter as much as money, family, and race. Those with more wealth or adult children had a much lower chance of readmission, and African Americans had a higher risk.

The most important factors that increased readmissions for acute myocardial infarction patients were whether they had been in nursing homes before their hospital stays and whether their hospitals cared for a high percentage of minority patients.

The researchers have started studying these same issues in Medicare patients who have had joint replacement.

Readmission rates after pneumonia, heart failure, and acute myocardial infarction hospitalizations are risk-adjusted for age, gender, and medical comorbidities and used to penalize hospitals. To asses