| Titre : | Function and Caregiver Support Associated With Readmissions During Home Health for Individuals With Dementia (2020) |
| Auteurs : | Sara Knox ; Brian Downer ; Allen Haas |
| Type de document : | Article |
| Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 101, n° 6, 2020) |
| Article en page(s) : | p. 1009-1016 |
| Note générale : | https://doi.org/10.1016/j.apmr.2019.12.021 |
| Langues: | Anglais |
| Descripteurs : |
HE Vinci Aidants ; Démence ; État de santé ; Organismes de prise en charge à domicile ; Réadaptation ; Réadmission du patient |
| Résumé : |
Objective
The purpose of this study was to determine the association between mobility, self-care, cognition, and caregiver support and 30-day potentially preventable readmissions (PPR) for individuals with dementia. Design This retrospective study derived data from 100% national Centers for Medicare and Medicaid Services data files from July 1, 2013, through June 1, 2015. Participants Criteria from the Home Health Claims-Based Rehospitalization Measure and the Potentially Preventable 30-Day Post Discharge Readmission Measure for the Home Health Quality Reporting Program were used to identify a cohort of 118,171 Medicare beneficiaries. Main Outcome Measure The 30-day PPR rates with associated 95% CIs were calculated for each patient characteristic. Multilevel logistic regression was used to study the relationship between mobility, self-care, caregiver support, and cognition domains and 30-day PPR during home health, adjusting for patient demographics and clinical characteristics. Results The overall rate of 30-day PPR was 7.6%. In the fully adjusted models, patients who were most dependent in mobility (odds ratio [OR], 1.59; 95% CI, 1.47-1.71) and self-care (OR, 1.73; 95% CI, 1.61-1.87) had higher odds for 30-day PPR. Patients with unmet caregiving needs had 1.11 (95% CI, 1.05-1.17) higher odds for 30-day PPR than patients whose caregiving needs were met. Patients with cognitive impairment had 1.23 (95% CI, 1.16-1.30) higher odds of readmission than those with minimal to no cognitive impairment. Conclusions Decreased independence in mobility and self-care tasks, unmet caregiver needs, and impaired cognitive processing at admission to home health are associated with risk of 30-day PPR during home health for individuals with dementia. Our findings indicate that deficits in mobility and self-care tasks have the greatest effect on the risk for PPR. |
| Disponible en ligne : | Oui |
| En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999320300824 |
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