Risk Factors for All-Cause Rehospitalization Among Medicare Recipients with Heart Failure Receiving Telehomecare

Telemed J E Health. 2017 Apr;23(4):305-312. doi: 10.1089/tmj.2016.0048. Epub 2016 Sep 30.

Abstract

Objective: To identify potential risk factors associated with rehospitalization among Medicare recipients with heart failure (HF) receiving telehomecare.

Materials and methods: This study is a nonexperimental, cross-sectional secondary data analysis of the Centers for Medicare and Medicaid (CMS) mandated assessment called the Outcome and Assessment Information Set (OASIS)-C, provided by a large home care company. A total of 526 patients who received telehomecare from January 1, 2011 to August 31, 2013 were included in the analyses, which used multiple logistic regression.

Results: The overall rate of rehospitalization was 36% while patients were receiving telehomecare. Moderately frail health status (p = 0.01), the presence of severe pain (p = 0.01), the presence of dermatologic problems (p = 0.03), and independence in dressing one's lower body (compared to slightly dependent [p = 0.01] or mostly dependent patient groups [p = 0.02]) were identified as risk factors for rehospitalization.

Conclusions: The risk factors identified from this study may be used to drive more effective telehomecare placements, and referrals for additional services among telehomecare patients with HF.

Keywords: cardiology; cardiovascular disease; home health monitoring; medical records; telehealth.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Centers for Medicare and Medicaid Services, U.S. / statistics & numerical data
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Health Status
  • Heart Failure / therapy*
  • Humans
  • Male
  • Medicare / statistics & numerical data*
  • Middle Aged
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / statistics & numerical data
  • Patient Readmission / statistics & numerical data*
  • Risk Factors
  • Telemedicine / statistics & numerical data*
  • United States