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'Social environmental factors' affect rehospitalization risk in home healthcare patients
Date:11/12/2012

ects occur. Patients' functional abilitytheir ability to take care of themselveswas influenced by their living arrangements and by the type and frequency of informal care they received.

The greater the difference between the patients' clinical condition and functional status, the greater the risk of rehospitalization. Social environmental factors contributed to the risk of repeated hospital admission by altering the balance between the patient's need for and ability to provide self-care.

With 'Self-Care Deficit' Leading to Repeat Hospitalizations

Changes in clinical condition placed increased demands on the patient's ability to care for himself or herself, while at the same time making it more difficult to provide self-care. Consistent with a central nursing theory, the resulting "self-care deficit" was linked to an increased risk of rehospitalization.

The amount of care and assistance received from informal caregivers had an important impact on self-care ability and rehospitalization risk. Other patient characteristics linked to self-care deficit included obesity and cognitive (intellectual) ability. Patients living alone were less likely to be rehospitalizedperhaps because those choosing to live alone were better able to functional independently and care for themselves.

Few previous studies have looked at how social environmental factors in general, and informal caregivers in particular, affect patient outcomes. Rehospitalization is considered a "major adverse event" in home care. "Rehospitalizations are costly and in many cases preventable," Dr Tao and colleagues explain. One recent study found that 20 percent of hospitalized Medicare beneficiaries are readmitted within 30 days, with costs accounting for one-sixth of the total Medicare budget.

Dr Tao and colleagues believe their study has implications for strategies to reduce unnecessary rehospitalizations and improve the quality of home healthcare.
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Contact: Connie Hughes
Connie.Hughes@wolterskluwer.com
646-674-6348
Wolters Kluwer Health
Source:Eurekalert

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