title: Determinants of health after hospital discharge: rationale and design of the Vanderbilt Inpatient Cohort Study (VICS).
abstract: BACKGROUND
  The period following hospital discharge is a vulnerable time for patients when errors and poorly coordinated care are common. Suboptimal care transitions for patients admitted with cardiovascular conditions can contribute to readmission and other adverse health outcomes. Little research has examined the role of health literacy and other social determinants of health in predicting post-discharge outcomes.
  
  
  METHODS
  The Vanderbilt Inpatient Cohort Study (VICS), funded by the National Institutes of Health, is a prospective longitudinal study of 3,000 patients hospitalized with acute coronary syndromes or acute decompensated heart failure. Enrollment began in October 2011 and is planned through October 2015. During hospitalization, a set of validated demographic, cognitive, psychological, social, behavioral, and functional measures are administered, and health status and comorbidities are assessed. Patients are interviewed by phone during the first week after discharge to assess the quality of hospital discharge, communication, and initial medication management. At approximately 30 and 90 days post-discharge, interviewers collect additional data on medication adherence, social support, functional status, quality of life, and health care utilization. Mortality will be determined with up to 3.5 years follow-up. Statistical models will examine hypothesized relationships of health literacy and other social determinants on medication management, functional status, quality of life, utilization, and mortality. In this paper, we describe recruitment, eligibility, follow-up, data collection, and analysis plans for VICS, as well as characteristics of the accruing patient cohort.
  
  
  CONCLUSIONS
  This research will enhance understanding of how health literacy and other patient factors affect the quality of care transitions and outcomes after hospitalization. Findings will help inform the design of interventions to improve care transitions and post-discharge outcomes.
authors.forename: Abby G
authors.initials: AG
authors.lastname: Meyers
authors.forename: Amanda
authors.initials: A
authors.lastname: Salanitro
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Wallston
authors.forename: Courtney
authors.initials: C
authors.lastname: Cawthon
authors.forename: Eduard E
authors.initials: EE
authors.lastname: Vasilevskis
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Goggins
authors.forename: Corinne M
authors.initials: CM
authors.lastname: Davis
authors.forename: Russell L
authors.initials: RL
authors.lastname: Rothman
authors.forename: Liana D
authors.initials: LD
authors.lastname: Castel
authors.forename: Katharine M
authors.initials: KM
authors.lastname: Donato
authors.forename: John F
authors.initials: JF
authors.lastname: Schnelle
authors.forename: Susan P
authors.initials: SP
authors.lastname: Bell
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Schildcrout
authors.forename: Chandra Y
authors.initials: CY
authors.lastname: Osborn
authors.forename: Frank E
authors.initials: FE
authors.lastname: Harrell
authors.affiliation: Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University, 1215 21st Ave S, Suite 6000 Medical Center East, Nashville 37232, TN, USA. sunil.kripalani@vanderbilt.edu.
authors.forename: Sunil
authors.initials: S
authors.lastname: Kripalani
mesh_terms: D054058:Acute Coronary Syndrome / Q000628:therapy; D000368:Aged; D003266:Continuity of Patient Care / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D057220:Health Literacy / Q000592:standards / Q000706:statistics & numerical data; D006304:Health Status; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D007297:Inpatients / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000592:standards / Q000706:statistics & numerical data*; D063868:Patient Outcome Assessment; D011446:Prospective Studies; D011787:Quality of Health Care / Q000592:standards / Q000706:statistics & numerical data; D012648:Self Care / Q000592:standards / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D064890:Social Determinants of Health / Q000706:statistics & numerical data; D012944:Social Support