title: Use of a homecare electronic health record to find associations between patient characteristics and re-hospitalizations in patients with heart failure using telehealth.
abstract: Data from homecare electronic health records were used to explore the association of patient characteristics with re-hospitalizations of patients with heart failure (HF) during a 60-day period of telemonitoring following hospital discharge. Data from 403 Medicare patients with HF who had used telehealth from 2008 to 2010 were analysed. There were 112 all-cause (29%) and 73 cardiac-related (19%) re-hospitalizations within 60 days of the start of telemonitoring. In adjusted analyses, the patients' number of medications and type of cardiac medications were significantly (P < 0.05) associated with an increased risk of re-hospitalization. After stratifying the sample by illness severity, age and gender, other significant (P < 0.05) predictors associated with an increased risk of all-cause and cardiac re-hospitalization were psychiatric co-morbidity, pulmonary and obesity co-morbidities within gender, beta blocker prescription in females and primary HF diagnosis in the oldest age stratum. The study's findings may assist homecare agencies seeking to allocate resources without compromising patient care.
authors.affiliation: School of Nursing, University of Texas, Austin, TX 78701-1499, USA. kradhakrishnan@mail.nur.utexas.edu
authors.forename: Kavita
authors.initials: K
authors.lastname: Radhakrishnan
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Jacelon
authors.forename: Carol
authors.initials: C
authors.lastname: Bigelow
authors.forename: Joan
authors.initials: J
authors.lastname: Roche
authors.forename: Jenna
authors.initials: J
authors.lastname: Marquard
authors.forename: Kathryn H
authors.initials: KH
authors.lastname: Bowles
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057286:Electronic Health Records; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008297:Male; D009511:New England; D010359:Patient Readmission / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D017216:Telemedicine