The Research on Social Risk Factors and Hospital Readmissions

The Research on Social Risk Factors and Hospital Readmissions

If your strategic decisions on population health rely heavily on evidence-based research, you may not like this infographic.  Above is a summary of findings from over 35 research studies on the correlations between four social risk factors and hospital readmissions (from a recent study by the National Academies Press (NAP). Just as the results of applying the same readmission strategy can yield different results between one health system and another, study findings can also be inconsistent.  If any lessons can be learned from this simplified research analysis, it’s that what has be proven for some, may not necessarily be repeated by others.

1. Philbin, E. F., G. W. Dec, P. L. Jenkins, and T. G. DiSalvo. 2001. Socioeconomic status as an independent risk factor for hospital readmission for heart failure. American Journal of Cardiology 87(12):1367–1371.|
2. Jiang, H. J., R. Andrews, D. Stryer, and B. Friedman. 2005. Racial/ethnic disparities in potentially preventable readmissions: The case of diabetes. American Journal of Public Health 95(9):1561–1567
3. Kim, H., J. S. Ross, G. D. Melkus, Z. Zhao, and K. Boockvar. 2010. Scheduled and unscheduled hospital readmissions among patients with diabetes. American Journal of Managed Care 16(10):760–767.
4. Kroch, E., M. Duan, J. Martin, and R. A. Bankowitz. 2015. Patient factors predictive of hospital readmissions within 30 days. Journal for Healthcare Quality.
5. Oronce, C. I. A., H. Shao, and L. Shi. 2015. Disparities in 30-day readmissions after total hip arthroplasty. Medical Care 53:924–930.
6. Eisner, M. D., P. D. Blanc, T. A. Omachi, E. H. Yelin, S. Sidney, P. P. Katz, L. M. Ackerson, G.Sanchez, I. Tolstykh, and C. Iribarren. 2011. Socioeconomic status, race and COPD health outcomes. Journal of Epidemiology and Community Health 65(1):26–34.
7. Blustein, J., K. Hanson, and S. Shea. 1998. Preventable hospitalizations and socioeconomic status. Health Affairs (Millwood) 17(2):177–189.
8. Foraker, R. E., K. M. Rose, C. M. Suchindran, P. P Chang, A. M. McNeill, and W. D. Rosamond. 2011. Socioeconomic status, Medicaid coverage, clinical comorbidity, and rehospitalization or death after an incident heart failure hospitalization atherosclerosis risk in communities cohort (1987 to 2004). Circulation: Heart Failure 4(3):308–316.
9. Maniar, H. S., J. M. Bell, M. R. Moon, B. F. Meyers, J. Marsala, J. S. Lawton, and R. J. Damiano, Jr. 2014. Prospective evaluation of patients readmitted after cardiac surgery: Analysis of outcomes and identification of risk factors. Journal of Thoracic and Cardiovascular Surgery 147(3):1013–1018.
10. Moore, C. D., K. Gao, and M. Shulan. 2013. Racial, income, and marital status disparities in hospital readmissions within a veterans-integrated health care network. Evaluation & the Health
11. Arbaje, A. I., J. L. Wolff, Q. L. Yu, N. R. Powe, G. F. Anderson, and C. Boult. 2008. Postdischarge environmental and socioeconomic factors and the likelihood of early hospital readmission among community-dwelling Medicare beneficiaries. Gerontologist 48(4):495–504.
12. Bernheim, S. M., J. A. Spertus, K. J. Reid, E. H. Bradley, R. A. Desai, E. D. Peterson, S. S. Rathore, S.-L. T. Normand, P. G. Jones, A. Rahimi, and H. M. Krumholz. 2007. Socioeconomic disparities in outcomes after acute myocardial infarction. American Heart Journal 153(2):313–319.
13. Sattler, E. L. P., J. S. Lee, and H. N. Young. 2015. Factors associated with inpatient hospital (re)admissions in Medicare beneficiaries in need of food assistance. Journal of Nutrition inGerontology and Geriatrics 34(2):228–244.
14. Hunter, T., R. S. Yoon, L. Hutzler, P. Band, V. Liublinksa, J. Slover, and J. A. Bosco. 2015. No evidence for race and socioeconomic status as independent predictors of 30-day readmission ratesfollowing orthopedic surgery. American Journal of Medical Quality 30(5):484–488.
15. Hu, J., M. D. Gonsahn, and D. R. Nerenz. 2014. Socioeconomic status and readmissions: Evidence from an urban teaching hospital. Health Affairs (Millwood) 33(5):778–785.
16. Smith, S. A., A. K. Hasan, P. F. Binkley, and R. E. Foraker. 2014. The impact of insurance and socioeconomic status on outcomes for patients with left ventricular assist devices. Journal of Surgical Research 191(2):302–308.
17. Jasti, H., E. M. Mortensen, D. S. Obrosky, W. N. Kapoor, and M. J. Fine. 2008. Causes and risk factors for rehospitalization of patients hospitalized with community-acquired pneumonia. Clinical Infectious Diseases 46(4):550–556.
18. Iloabuchi, T. C., D. Mi, W. Tu, and S. R. Counsell. 2014. Risk factors for early hospital readmission in low-income elderly adults. Journal of the American Geriatrics Society 62(3):489–494.
19. Garrison, G. M., M. P. Mansukhani, and B. Bohn. 2013. Predictors of thirty-day readmission among hospitalized family medicine patients. Journal of the American Board of Family Medicine26(1):71–77.
20. Howie-Esquivel, J., and J. G. Spicer. 2012. Association of partner status and disposition with rehospitalization in heart failure patients. American Journal of Critical Care 21(3):e65–e73.
21. Iwashyna, T. J., and N. A. Christakis. 2003. Marriage, widowhood, and health-care use. Social Science and Medicine 57(11):2137–2147.
22. Metersky, M. L., M. J. Fine, and E. M. Mortensen. 2012. The effect of marital status on the presentation and outcomes of elderly male veterans hospitalized for pneumonia. CHEST 142(4):982–987.
23. Watkins, T., M. Mansi, J. Thompson, I. Mansi, and R. Parish. 2013. Effect of marital status on clinical outcome of heart failure. Journal of Investigative Medicine 61(5):835–841
24. Hamner, J. B., and K. J. Ellison. 2005. Predictors of hospital readmission after discharge in patients with congestive heart failure. Heart and Lung: Journal of Acute and Critical Care 34(4):231–239.
25. Calvillo-King, L., D. Arnold, K. J. Eubank, M. Lo, P. Yunyongying, H. Stieglitz, and E. A. Halm. 2013. Impact of social factors on risk of readmission or mortality in pneumonia and heart failure: Systematic review. Journal of General Internal Medicine 28(2):269–282.
26. Damiani, G., E. Salvatori, G. Silvestrini, I. Ivanova, L. Bojovic, L. Iodice, and W. Ricciardi. 2015. Influence of socioeconomic factors on hospital readmissions for heart failure and acute myocardial infarction in patients 65 years and older: Evidence from a systematic review. Clinical Interventions in Aging 10:237–245.
27. Aujesky, D., M. K. Mor, M. Geng, R. A. Stone, M. J. Fine, and S. A. Ibrahim. 2009. Predictors of early hospital readmission after acute pulmonary embolism. Archives of Internal Medicine 169(3):287–293.
28. Girotti, M. E., T. Shih, S. Revels, and J. B. Dimick. 2014. Racial disparities in readmissions and site of care for major surgery. Journal of the American College of Surgeons 218(3):423–430.
29. Joynt, K. E., E. J. Orav, and A. K. Jha. 2011. Thirty-day readmission rates for Medicare beneficiaries by race and site of care. Journal of the American Medical Association 305(7):675–681.
30. McHugh, M. D., J. M. Carthon, and X. L. Kang. 2010. Medicare readmissions policies and racial and ethnic health disparities: A cautionary tale. Policy, Politics & Nursing Practice 11(4):309–316.
31. Silber, J. H., P. R. Rosenbaum, R. R. Kelz, D. J. Gaskin, J. M. Ludwig, R. N. Ross, B. A. Niknam, A. Hill, M. Wang, O. Even-Shoshan, and L. A. Fleisher. 2015. Examining causes of racial disparities in general surgical mortality. Medical Care 53(7):619–629.
32. Tsai, T. C., E. J. Orav, and K. E. Joynt. 2014. Disparities in surgical 30-day readmission rates for Medicare beneficiaries by race and site of care. Annals of Surgery 259(6):1086–1090. Vivo, R. P., S. R. Krim, L. Liang, M. Neely, A. F. Hernandez, Z. J. Eapen, E. D. Peterson, D. L. Bhatt, P. A. Heidenreich, C. W. Yancy, and G. C. Fonarow. 2014. Short- and long-term rehospitalization and mortality for heart failure in 4 racial/ethnic populations. Journal of the American Heart Association 3(5).
33. Vivo, R. P., S. R. Krim, L. Liang, M. Neely, A. F. Hernandez, Z. J. Eapen, E. D. Peterson, D. L. Bhatt, P. A. Heidenreich, C. W. Yancy, and G. C. Fonarow. 2014. Short- and long-term rehospitalization and mortality for heart failure in 4 racial/ethnic populations. Journal of the American Heart Association 3(5).
34. Rodriguez, F., K. E. Joynt, L. Lopez, F. Saldana, and A. K. Jha. 2011. Readmission rates for Hispanic Medicare beneficiaries with heart failure and acute myocardial infarction. American Heart Journal 162(2):U254–U273.
35. Stahler, G. J., J. Mennis, R. Cotlar, and D. A. Baron. 2009. The influence of neighborhood environment on treatment continuity and rehospitalization in dually diagnosed patients discharged from acute inpatient care. American Journal of Psychiatry 166(11):1258–1268.
36. Kennedy, B. S., S. P. Fortmann, and R. S. Stafford. 2007. Elective and isolated carotid endarterectomy: Health disparities in utilization and outcomes, but not readmission. Journal of the National Medical Association 99(5):480–488.
37. Ross, J. S., G. K. Mulvey, B. Stauffer, V. Patlolla, S. M. Bernheim, P. S. Keenan, and H. M. Krumholz. 2008. Statistical models and patient predictors of readmission for heart failure: A systematic review. Archives of Internal Medicine 168(13):1371–1386.

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