Factors That Influence 7- and 30-day Readmissions After Heart Failure Hospitalization
| atmire.migration.oldid | 3546 | |
| dc.contributor.advisor | King-Shier, Kathryn | |
| dc.contributor.advisor | Quan, Hude | |
| dc.contributor.author | Eastwood, Catherine Ann | |
| dc.date.accessioned | 2015-09-09T16:58:24Z | |
| dc.date.available | 2015-11-20T08:00:36Z | |
| dc.date.issued | 2015-09-09 | |
| dc.date.submitted | 2015 | en |
| dc.description.abstract | Patients with heart failure (HF) frequently return to hospital within days of discharge, yet contributing factors have not been fully explored. Hospitalizations place stress on the patient, family, and healthcare system, and require closer examination to determine potential avoidability and targets for intervention. Thus, current factors that influence readmissions after HF hospitalization in Alberta were examined. A two-phased case-control design was used to compare patients who were readmitted and not readmitted after hospitalization for HF. In Phase One, an 8-year period of hospital discharge abstract data was analyzed. The rate of unplanned all-cause readmission was 6% and 18% within 7 and 30 days respectively after discharge. After risk adjustment for age, sex, and year, all-cause readmission within 7 days after discharge was associated with having kidney disease, and readmission within 30 days was associated with having cancer, pulmonary, liver, and kidney disease. At both time intervals, discharge with homecare services was associated with increased risk of readmission, and discharge from a hospital with HF services was associated with lower risk of readmission. In Phase Two, a health record audit was undertaken for a more detailed examination of factors associated with readmission within 7 days of discharge and potential avoidability. Matched pairs of patients discharged from Calgary hospitals were identified from the Phase One sample. Patients who were frail or had a specialist as attending physician were more likely to be readmitted. Patients who were instructed to see a physician within 1 week of discharge were less likely to be readmitted. Common reasons for readmission included HF then gastrointestinal, other cardiac, and respiratory diagnoses. Almost 60% of readmissions were deemed potentially avoidable based on explicit criteria developed from past research. Several factors were associated with readmission within the 2 time intervals studied. Despite care by specialists and referral to HF clinics, complex frail patients were discharged with unresolved symptoms or inadequate community support. It is important that criteria be developed to screen for frailty, discharge readiness, and to determine avoidability. | en_US |
| dc.identifier.citation | Eastwood, C. A. (2015). Factors That Influence 7- and 30-day Readmissions After Heart Failure Hospitalization (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/26154 | en_US |
| dc.identifier.doi | http://dx.doi.org/10.11575/PRISM/26154 | |
| dc.identifier.uri | http://hdl.handle.net/11023/2443 | |
| dc.language.iso | eng | |
| dc.publisher.faculty | Graduate Studies | |
| dc.publisher.faculty | Nursing | |
| dc.publisher.institution | University of Calgary | en |
| dc.publisher.place | Calgary | en |
| dc.rights | University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission. | |
| dc.subject | Epidemiology | |
| dc.subject | Health Care Management | |
| dc.subject | Nursing | |
| dc.subject.classification | Readmission | en_US |
| dc.subject.classification | Heart Failure | en_US |
| dc.subject.classification | Quality of Care | en_US |
| dc.subject.classification | Avoidability | en_US |
| dc.subject.classification | Frailty | en_US |
| dc.subject.classification | Health record audit | en_US |
| dc.title | Factors That Influence 7- and 30-day Readmissions After Heart Failure Hospitalization | |
| dc.type | doctoral thesis | |
| thesis.degree.discipline | Nursing | |
| thesis.degree.grantor | University of Calgary | |
| thesis.degree.name | Doctor of Philosophy (PhD) | |
| ucalgary.item.requestcopy | true |