title: Risk factors for early hospital readmission in low-income elderly adults.
abstract: OBJECTIVE
  To identify risk factors for early hospital readmission in low-income community-dwelling older adults.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  University-affiliated urban safety-net healthcare system in Indianapolis, Indiana.
  
  
  METHODS
  Community-dwelling adults aged 65 and older with annual income less than 200% of the federal poverty level and enrolled in the Geriatric Resources for Assessment and Care of Elders (GRACE) randomized controlled trial (N = 951).
  
  
  METHODS
  Participant health and functional status at baseline and 6, 12, 18, and 24 months. Early readmission was defined as a repeat hospitalization occurring within 30 days of a prior hospital discharge. Candidate risk factors included sociodemographic characteristics, health and functional status, prior care, lifestyle, and satisfaction with care.
  
  
  RESULTS
  Of 457 index admissions in 328 participants, 85 (19%) were followed by an early readmission. The independent risk factors for early readmission identified according to regression analysis were living alone (odds ratio (OR) = 1.71, 95% confidence interval (CI) = 1.02-2.87), fair or poor satisfaction with primary care physician (OR = 2.12, 95% CI = 1.01-4.46), not having Medicaid (OR = 1.80, 95% CI = 1.05-3.11), receiving a new assistive device in the past 6 months (OR = 2.26, 95% CI = 1.26-4.05), and staying in a nursing home in the past 6 months (OR = 5.08, 95% CI = 1.56-16.53). Age, race, sex, education, and chronic diseases were not associated with early readmission.
  
  
  CONCLUSIONS
  A broad range of nonmedical risk factors played a greater role than previously recognized in early hospital readmission of low-income seniors.
authors.affiliation: Department of Medicine, School of Medicine, Indiana University, Indianapolis, Indiana.
authors.forename: Tochukwu C
authors.initials: TC
authors.lastname: Iloabuchi
authors.forename: Deming
authors.initials: D
authors.lastname: Mi
authors.forename: Wanzhu
authors.initials: W
authors.lastname: Tu
authors.forename: Steven R
authors.initials: SR
authors.lastname: Counsell
mesh_terms: D000368:Aged; D016638:Critical Illness / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D007196:Indiana / Q000453:epidemiology; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011203:Poverty; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
keywords: hospital readmission; low-income seniors; risk factors