Place Where Older Adults Live Before Hospitalization May Affect Risk of Readmission

A study published in the Canadian Medical Association Journal found 40 percent of older adults who leave the hospital are discharged to home care or a long-term care community, which, combined with where they lived prior to hospitalization, affects their risk of readmission, reports News-Medical . "The information from this study will contribute to a better understanding of the extent to which complicated transitions to and from hospital influence readmission among older adults, which is essential for system planning, performance measurement, and the targeting and testing of interventions to improve transitions and reduce readmissions," notes the University of Alberta's Andrea Gruneir. The researchers examined 701,527 hospitalized adults over 65 in Ontario, determining that 31.5 percent were discharged to home care and 9.5 percent to long-term care, with 3 percent newly admitted to long-term care. More than half were women and 40 percent had five or more chronic conditions. Ninety-eight percent had visited a doctor at least once during the year before hospital admission, 47 percent had visited the emergency department, and 10 percent had been admitted. Persons discharged with home care were the most likely to be readmitted, and when readmitted, 19 percent were there for two or more weeks and nearly 20 percent were designated as alternate level of care (ALC), the longest of any study cohort. Conversely, people who were discharged to long-term care as a new admission were least likely to be readmitted, but their first hospital stay was most often for dementia. More than 80 percent were in the hospital for two or more weeks and were designated as ALC, which means they no longer require acute hospital care but cannot be discharged as the appropriate level of care required is not available in another setting.