Predictors of 30-Day Hospital Readmissions Among Heart Failure Patients

Saturday, 21 July 2018: 9:30 AM

Lydia Honorata Albuquerque, DNP
Department of Cardiology, University Hospital, Livingston, NJ, USA

Abstract

Heart failure is the leading cause of hospital readmissions among patients older than 65 years of age (Mozzafarian, 2016). The purpose of this quantitative, descriptive correlational research design was to investigate the relationship between self-reported functional status as measured by the New York heart failure Association (NYHA) Functional Classification and health related quality of life (HRQOL) as measured by the Minnesota living with heart failure questionnaire (MLHFQ) to 30 day hospital re-admission rates among patients with Heart failure (HF). Two hypothesis were tested in this study. 1) There will be a positive correlation between increase in limitations as measured by functional status and hospital readmissions 2) There will be a positive correlation between increase in health related quality of life as measured by the Minnesota living with heart failure questionnaire (MLHFQ) to 30 day hospital readmissions. The Wilson and Clearly model guided this research. The sample consisted of 66 participants. A Pearson Chi-square was used to test the statistical support for the hypothesis. The computed chi-square p value was .044, which is under the required <.05. There is a statistical significance which supports the hypothesis that NYHA functional status classification is a predictor of hospital readmission. The average quality of life score among participants who were admitted was 85.6 while those who were not admitted had an average score 65.9. The independent sample t-test was done to test for a relationship between health related quality of life and readmission. The t values were all above 2 with p<.05. In each case those readmitted had significantly lower quality of life scores for all three measures (Physical, Emotional and other) with the mean difference shown to be statistically significant. Given the non-normal distribution of the quality of life scores, the t-test was supplemented with a Mann-Whitney U Test to test the significance of the differences in mean quality of life score by admission status. Results confirmed that there was a statistically significant difference (Mann- Whitney U=319.0; p=.008, p <0.01). A one- way ANOVA was calculated comparing the demographic variable to 30 day hospital readmission, significant difference was found between monthly income and readmission (F=2.864, p<. 05) and the times participants were admitted in the hospital in past one year to 30 day readmission (F=3.333, p< .010). The results of this study provide health care providers information about predictors of 30 day readmission among participants diagnosed with HF.