Risk Factors for All-Cause Rehospitalization Among Medicare Recipients with Heart Failure Receiving Telehomecare.
To identify potential risk factors associated with rehospitalization among Medicare recipients with heart failure (HF) receiving telehomecare.



This study is a nonexperimental, cross-sectional secondary data analysis of the Centers for Medicare and Medicaid (CMS) mandated assessment called the Outcome and Assessment Information Set (OASIS)-C, provided by a large home care company. A total of 526 patients who received telehomecare from January 1, 2011 to August 31, 2013 were included in the analyses, which used multiple logistic regression.



The overall rate of rehospitalization was 36% while patients were receiving telehomecare. Moderately frail health status (p = 0.01), the presence of severe pain (p = 0.01), the presence of dermatologic problems (p = 0.03), and independence in dressing one's lower body (compared to slightly dependent [p = 0.01] or mostly dependent patient groups [p = 0.02]) were identified as risk factors for rehospitalization.



The risk factors identified from this study may be used to drive more effective telehomecare placements, and referrals for additional services among telehomecare patients with HF.
1 University of Pennsylvania School of Nursing , Philadelphia, Pennsylvania.
Youjeong
Y
Kang
1 University of Pennsylvania School of Nursing , Philadelphia, Pennsylvania.|2 Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing , Philadelphia, Pennsylvania.
Matthew D
MD
McHugh
1 University of Pennsylvania School of Nursing , Philadelphia, Pennsylvania.
Jesse
J
Chittams
1 University of Pennsylvania School of Nursing , Philadelphia, Pennsylvania.|3 vanAmeringen Professor in Nursing Excellence, University of Pennsylvania School of Nursing , Philadelphia, Pennsylvania.|4 Director of the Center for Home Care Policy and Research, Visiting Nurse Service of New York, New York, New York.
Kathryn H
KH
Bowles
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D014487:Centers for Medicare and Medicaid Services, U.S. / Q000706:statistics & numerical data; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012307:Risk Factors; D017216:Telemedicine / Q000706:statistics & numerical data*; D014481:United States
cardiology; cardiovascular disease; home health monitoring; medical records; telehealth
Prev Vet Med. 2000 May 30;45(1-2):23-41
10802332
Am J Med. 2000 Oct 1;109(5):386-90
11020395
J Intraven Nurs. 2001 Mar-Apr;24(2):85-94
11836838
Res Nurs Health. 2003 Apr;26(2):118-27
12652608
Drugs. 2003;63(6):525-34
12656651
J Healthc Qual. 2003 Mar-Apr;25(2):4-10; quiz 10-1
12659074
Res Nurs Health. 2003 Aug;26(4):273-83
12884416
Dermatol Surg. 2004 Jun;30(6):939-41
15171776
Health Serv Res. 2004 Oct;39(5):1449-65
15333117
J Cardiovasc Nurs. 2004 Nov-Dec;19(6 Suppl):S75-83
15529077
Home Health Care Serv Q. 2005;24(3):23-38
16203688
J Card Fail. 2006 May;12(4):307-13
16679265
J Am Podiatr Med Assoc. 2006 Sep-Oct;96(5):442-4
16988176
West J Nurs Res. 2006 Dec;28(8):902-17
17099104
Circulation. 2007 Feb 20;115(7):928-35
17309939
Home Health Care Serv Q. 2007;26(4):21-36
18032198
Am J Clin Dermatol. 2008;9(3):141-6
18429642
J Card Fail. 2008 May;14(4):276-82
18474339
J Clin Nurs. 2008 Apr;17(7B):253-9
18578801
J Pain Symptom Manage. 2008 Nov;36(5):497-504
18619766
Arch Intern Med. 2008 Jul 14;168(13):1371-86
18625917
Eur J Cardiovasc Nurs. 2009 Sep;8(3):169-73
19150255
Home Health Care Serv Q. 2009;28(1):45-57
19266370
N Engl J Med. 2009 Apr 2;360(14):1418-28
19339721
J Pain Symptom Manage. 2009 Nov;38(5):698-707
19733032
J Telemed Telecare. 2009;15(7):344-50
19815903
J Am Board Fam Med. 2010 May-Jun;23(3):413-7
20453188
Home Healthc Nurse. 2010 Jun;28(6):353-62; quiz 363-4
20539138
J Cardiovasc Nurs. 2010 Sep-Oct;25(5):E27-40
20671564
Home Health Care Serv Q. 2010 Oct;29(4):155-70
21153996
J Wound Ostomy Continence Nurs. 2011 Jan-Feb;38(1):77-87
21287773
Home Healthc Nurse. 2011 Jun;29(6):368-74
21633228
JAMA. 2011 Oct 19;306(15):1688-98
22009101
J Am Coll Cardiol. 2012 Jan 10;59(2):97-104
22222071
Health Serv Res. 2012 Dec;47(6):2316-38
22524242
Circulation. 2012 Jul 24;126(4):501-6
22825412
J Card Fail. 2012 Oct;18(10):776-83
23040113
Can Fam Physician. 2012 Oct;58(10):e551-3
23064932
Home Health Care Serv Q. 2012;31(4):267-301
23216513
Home Health Care Serv Q. 2013;32(1):57-74
23438509
Appl Clin Inform. 2012 Nov 21;3(4):419-36
23646088
Heart Fail Clin. 2013 Jul;9(3):303-20, vi
23809417
Appl Clin Inform. 2013 Oct 09;4(4):465-75
24454576
J Appl Gerontol. 2014 Jun;33(4):474-93
24781967
Asian Nurs Res (Korean Soc Nurs Sci). 2013 Jun;7(2):53-60
25029922
Heart Lung. 2015 Mar-Apr;44(2):107-12
25576085
Home Health Care Serv Q. 2004 Feb 2;22(4):43-63
29016255
J Health Soc Behav. 1995 Mar;36(1):1-10
7738325