Timing of Home Health Care Initiation and 30-Day Rehospitalizations among Medicare Beneficiaries with Diabetes by Race and Ethnicity.

Authors

Jamie M Smith, College of Nursing, Thomas Jefferson University, Philadelphia, PA 19107, USA; School of Nursing, Rutgers, The State University of New Jersey, Newark, NJ 07108, USAFollow
Haiqun Lin, School of Nursing, Rutgers, The State University of New Jersey, Newark, NJ 07108, USA; School of Public Health, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
Charlotte Thomas-Hawkins, School of Nursing, Rutgers, The State University of New Jersey, Newark, NJ 07108, USA
Jennifer Tsui, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA 90033, USA
Olga F Jarrín, School of Nursing, Rutgers, The State University of New Jersey, Newark, NJ 07108, USA; Institute for Health, Health Care Policy, and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA

Document Type

Article

Publication Date

5-25-2021

Comments

This article is the author's final published version in International Journal of Environmental Research and Public Health, Volume 18, Issue 11, May 2021, Article number 5623.

The published version is available at https://doi.org/10.3390/ijerph18115623.

Copyright © 2021 by the authors.

Abstract

Older adults with diabetes are at elevated risk of complications following hospitalization. Home health care services mitigate the risk of adverse events and facilitate a safe transition home. In the United States, when home health care services are prescribed, federal guidelines require they begin within two days of hospital discharge. This study examined the association between timing of home health care initiation and 30-day rehospitalization outcomes in a cohort of 786,734 Medicare beneficiaries following a diabetes-related index hospitalization admission during 2015. Of these patients, 26.6% were discharged to home health care. To evaluate the association between timing of home health care initiation and 30-day rehospitalizations, multivariate logistic regression models including patient demographics, clinical and geographic variables, and neighborhood socioeconomic variables were used. Inverse probability-weighted propensity scores were incorporated into the analysis to account for potential confounding between the timing of home health care initiation and the outcome in the cohort. Compared to the patients who received home health care within the recommended first two days, the patients who received delayed services (3-7 days after discharge) had higher odds of rehospitalization (OR, 1.28; 95% CI, 1.25-1.32). Among the patients who received late services (8-14 days after discharge), the odds of rehospitalization were four times greater than among the patients receiving services within two days (OR, 4.12; 95% CI, 3.97-4.28). Timely initiation of home health care following diabetes-related hospitalizations is one strategy to improve outcomes.

Recommended Citation

Smith, Jamie M; Lin, Haiqun; Thomas-Hawkins, Charlotte; Tsui, Jennifer; and Jarrín, Olga F, "Timing of Home Health Care Initiation and 30-Day Rehospitalizations among Medicare Beneficiaries with Diabetes by Race and Ethnicity." (2021). College of Nursing Faculty Papers & Presentations. Paper 109.
https://jdc.jefferson.edu/nursfp/109

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

PubMed ID

34070282

Language

English