Discharge Location Disagreements and Rehospitalization Risk among Frail and Elderly Adults

1Mount Sinai School of Medicine, New York, NY
2Memorial Sloan Kettering Cancer Center, New York, NY
3Mount Sinai School of Medicine, New York, NY

Meeting: Hospital Medicine 2010, April 8-11, Washington, D.C.

Abstract number: 47

Background:

Rehospitalizations are costly and can be disruptive for patient cane. To our knowledge, no study has examined the impact of patient agreement with recommendations for the place of discharge as a cause of rehospitalization.

Purpose:

Our hypothesis was that for frail, hospitalized elderly adults, disagreement between patients and the clinical team's recommended place of discharge would be associated with a higher rate of rehospitalization.

Description:

We retrospectively examined a cohort of hospitalized older adults managed by a geriatrics inpatient service between July 1, 2007, and June 30, 2008. at Mount Sinai Hospital in New York City. We excluded patients who died during the index hospitalization or were discharged to hospice. Our main outcome was rehospitalization within 30 days at either Mount Sinai Hospital, identified from hospital billing data, or elsewhere, identified by review of ambulatory care physician notes after index discharge. Charts were reviewed to ascertain physical therapist discharge recommendation and actual place of discharge. We compared rehospitalization rates between patients whose discharge location disagreed and agreed with the recommended place of discharge using Student t tests. Among 514 patients originally hospitalized, 158 (30.7%) were readmitted within 30 days. The average age was 83, 75% were female, and 90% were prescribed > 5 medications. There were 42 patients (8%) for whom the actual place of discharge disagreed with the recommendation. Readmission rates were not significantly different between patients whose discharge location disagreed (14 of 42; 33.3%) and agreed (144 of 472; 30.5%) with the recommended place of discharge (odds ratio = 1.14,95% Cl 0.58–2.23; P = 0.71).

Conclusions:

Discharge disagreements were not associated with increased risk of rehospitalizalion among frail, elderly adults, perhaps a reassuring sign that patient preferences are also important during discharge planning.

Author Disclosure:

A. Dinescu, none; B. Korc‐Grodzicki. none; J. Ross, Mount Sinai Hospital, National Institute on Aging (K08 AG032886) and by the American Federation of Aging Research through the Paul B. Beeson Career Development Award Program.

To cite this abstract:

Dinescu A, Korc‐Grodzicki B, Ross J. Discharge Location Disagreements and Rehospitalization Risk among Frail and Elderly Adults. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 47. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/discharge-location-disagreements-and-rehospitalization-risk-among-frail-and-elderly-adults/. Accessed July 24, 2019.

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