Poster Presentation
Wednesday, 19 July 2006
9:30 AM - 10:00 AM
Wednesday, 19 July 2006
2:30 PM - 3:00 PM
The Relationship of Predisposing Factors to Post-Discharge Service Use for Hospitalized Elders with Heart Failure
Paula Roe-Prior, PhD, RN, Nursing, University of Scranton, Scranton, PA, USA
| Learning Objective #1: identify elders hospitalized in heart failure at risk for poor-postdischarge outcomes.
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| Learning Objective #2: understand the effect of predisposing factors, such as sociodemographics, on the post-discharge service use for elders who had been hospitalized in heart failure. |
Background: Using the Andersen Health Behavioral Model as a conceptual framework, the current study was performed to evaluate whether predisposing factors (sociodemographics) contributed in excess of previously identified need variables (severity of disease indicators) to characterize hospitalized elders at high risk for poor post-discharge outcomes such as rehospitalizations, emergency department (ED) use, and unscheduled physician(MD) visits over 12 weeks post discharge. The predisposing factors studied were age, sex, marital status, living situation, income, and education.
Sample: The 103 participants were primarily female (55.3%), white (69.9%), unmarried (57.3%), and not working (92.2%). The average age was 78 with an average length of index hospital stay of 7 days. The majority of subjects had a high school diploma or less (71.6%) and a yearly income of less than $20,000 (67.9%).
Results: There were 43 patients with all-cause rehospitalizations over the 12 week period. None of the predisposing factors were significantly correlated with all-cause rehospitalization or heart failure-related readmissions. Thirty-seven patients had acute unscheduled MD visits with the only significant correlation a patient being of black race (r =.357, p= < .0001). There were 18 patients with a total of 22 ED visits over the 12 week period. The only predisposing factor significant for predicting ED visits was lower patient education (r= -.215, p = .030).
Conclusion: The results of this study indicate that predisposing factors are less important than need factors in relation to service use. Because race has been shown to affect access to health care, black heart failure patients may not be receiving the same quality of health care as white patients. An explanation for the relationship of a lower level of education to ED use may be that these patients may have a harder time managing their complex therapeutic regime and may need more intensive monitoring.
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