title: Factors predicting rehospitalization of elderly patients in a postacute skilled nursing facility rehabilitation program.
abstract: OBJECTIVE
  To examine potential risk factors for rehospitalization of skilled nursing facility (SNF) rehabilitation patients.
  
  
  METHODS
  Retrospective review of rehabilitation charts.
  
  
  METHODS
  SNF rehabilitation beds (n=114) at a 514-bed urban, academic nursing home that receives patients from tertiary care hospitals.
  
  
  METHODS
  Consecutive rehabilitation patients (n=50) who were rehospitalized during days 4 to 30 of rehabilitation, compared with a matched group of rehabilitation patients (n=50) who were discharged without rehospitalization.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Data on potential risk factors were collected: demographics, medical history, conditions associated with preceding hospitalization, and initial rehabilitation examination and laboratory values. The clinical conditions precipitating rehospitalizations were noted.
  
  
  RESULTS
  Sixty-two percent of rehospitalizations were related to complications or recurrence of the same medical condition that was treated during the preceding hospitalization. The rehospitalized group had significantly more comorbidities including anemia (P=.001) and malignant solid tumors (P<.001), index hospitalizations involving a gastrointestinal condition (P=.001), needed more assistance with eating (P=.001) and walking (P=.03), and had lower hemoglobin (P=.002) and albumin levels (P<.001). A logistic regression model found that the strongest predictors for rehospitalization are a history of a malignant solid tumor (odds ratio [OR]=10.10), a recent hospitalization involving gastrointestinal conditions (OR=4.62), and a low serum albumin level (with each unit decrease in albumin, the odds of rehospitalization are 4 times greater [OR=.24, P=.005]).
  
  
  CONCLUSIONS
  Comorbid conditions, reasons for index hospitalization, and laboratory values are associated with an increased risk for rehospitalization. Further studies are needed to identify high-risk elderly patients and target interventions to minimize rehospitalizations.
authors.affiliation: Department of Medical Affairs, Jewish Home Lifecare, New York, NY, USA.
authors.forename: Wen
authors.initials: W
authors.lastname: Dombrowski
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Yoos
authors.forename: Richard
authors.initials: R
authors.lastname: Neufeld
authors.forename: Chaim Y
authors.initials: CY
authors.lastname: Tarshish
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D015897:Comorbidity; D017050:Episode of Care; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012866:Skilled Nursing Facilities