title: Association of partner status and disposition with rehospitalization in heart failure patients.
abstract: BACKGROUND
  Sociodemographic variables that are predictors of rehospitalization for heart failure may better inform hospital discharge strategies.
  
  
  OBJECTIVE
  (1) To determine whether sociodemographic variables are predictors of hospital readmission, (2) to determine whether sociodemographic or laboratory variables differ by age group as predictors of readmission, and (3) to compare whether patients' discharge disposition differs by age group in predicting readmission.
  
  
  METHODS
  Retrospective chart review of hospitalized patients with heart failure admitted in 2007.
  
  
  RESULTS
  Mean age was 68 (SD, 17) years for the 809 patients, with slightly more than one-third (n = 311, 38%) reporting a legal partner. Fewer than half (n = 359, 44%) were white. Almost one-third (n = 261, 32%) were rehospitalized within 90 days. Multivariable analysis revealed that patients younger than 65 years old and not partnered were at 1.8 times greater risk for being readmitted 90 days after discharge (P = .02; 95% CI, 0.33-0.92). Patients who were 65 years and older and not partnered were at 2.2 times greater risk for readmission (P = .01; 95% CI, 0.25-0.85) after creatinine level and discharge disposition were controlled for. For older patients discharged to home or to home with home services, the risk of readmission was 2.6 times greater than that for patients discharged to a skilled nursing facility (P = .02; 95% CI, 1.20-5.56).
  
  
  CONCLUSIONS
  The absence of a partner was predictive of readmission in all patients. Older patients with heart failure who were discharged to a skilled nursing facility had lower readmission rates. The effect of partner and disposition status may suggest a proxy for social support. Strategies to provide social support during discharge planning may have an effect on hospital readmission rates.
authors.affiliation: Department of Physiological Nursing, University of California, San Francisco, 94143, USA. jill.howie-esquivel@nursing.ucsf.edu
authors.forename: Jill
authors.initials: J
authors.lastname: Howie-Esquivel
authors.forename: Joan Gygax
authors.initials: JG
authors.lastname: Spicer
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019937:Diagnostic Techniques and Procedures; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D007902:Length of Stay; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data*; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors