Risk of Hospital Readmission among Dual Eligible Population in Arizona: Rural Vs Urban.

Persistent Link:
http://hdl.handle.net/10150/297032
Title:
Risk of Hospital Readmission among Dual Eligible Population in Arizona: Rural Vs Urban.
Author:
Baidoo, Bismark
Issue Date:
2013
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
Purpose: The purpose of this research was to examine and compare readmissions between the rural and urban areas for dual eligible patients in Arizona. The study also examined if living in an area of high socioeconomic status as opposed to living in an area of low socioeconomic status affects patient's risk of all-cause-30-day readmission. Methods: The study used data on dual eligible members who were continuously enrolled in AHCCCS and the University of Arizona Health Network between January 1st, 2011 and November 30th, 2012. The outcomes of interest in this study were risk of all-cause-30-day readmission, length of stay at index admission, and cost of readmission (i.e. amount paid by the University of Arizona Health Network). Log-binomial regression, Poison regression, and gamma regressions were used to model risk of readmission, length of stay at index admission, and cost of readmissions respectively. Results: Readmission of dual eligible patients in this sample was not related to residential location of patients. All-cause-30-day readmission did not differ for rural dual eligible patients and urban dual eligible patients. Readmission of dual eligible patients in this sample was not related to socioeconomic conditions. Dual eligible patients discharged in the year 2011 had a significantly higher risk of all-cause-30-day readmission than those discharged in the year 2012 (RR=1.05; p=0.03). Dual eligible patients discharged to skilled nursing facilities had a higher all-cause-30-day readmission risk compared to those discharged home. Length of stay at index admission was not associated with residential location. Patients admitted in the year 2011 were more likely to stay longer than those admitted in 2012 (IRR=1.13; p<.0001).The longer a dual eligible patient stayed during their readmission, the more their cost of readmission. (RR=1.33; p=0.0024). Conclusions: Readmission was neither associated with residential location nor socioeconomic condition. Cost associated with all-cause-30-day readmissions was not associated with residential location of the patients. The study also concludes that length of stay at index admission did not differ with socioeconomic conditions of the areas patients lived. It also concludes that year of discharge was associated with their risk of all-cause-30-day readmission.
Type:
text; Electronic Dissertation
Keywords:
Pharmaceutical Sciences
Degree Name:
Ph.D.
Degree Level:
doctoral
Degree Program:
Graduate College; Pharmaceutical Sciences
Degree Grantor:
University of Arizona
Advisor:
Slack, Marion K.

Full metadata record

DC FieldValue Language
dc.language.isoenen_US
dc.titleRisk of Hospital Readmission among Dual Eligible Population in Arizona: Rural Vs Urban.en_US
dc.creatorBaidoo, Bismarken_US
dc.contributor.authorBaidoo, Bismarken_US
dc.date.issued2013-
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractPurpose: The purpose of this research was to examine and compare readmissions between the rural and urban areas for dual eligible patients in Arizona. The study also examined if living in an area of high socioeconomic status as opposed to living in an area of low socioeconomic status affects patient's risk of all-cause-30-day readmission. Methods: The study used data on dual eligible members who were continuously enrolled in AHCCCS and the University of Arizona Health Network between January 1st, 2011 and November 30th, 2012. The outcomes of interest in this study were risk of all-cause-30-day readmission, length of stay at index admission, and cost of readmission (i.e. amount paid by the University of Arizona Health Network). Log-binomial regression, Poison regression, and gamma regressions were used to model risk of readmission, length of stay at index admission, and cost of readmissions respectively. Results: Readmission of dual eligible patients in this sample was not related to residential location of patients. All-cause-30-day readmission did not differ for rural dual eligible patients and urban dual eligible patients. Readmission of dual eligible patients in this sample was not related to socioeconomic conditions. Dual eligible patients discharged in the year 2011 had a significantly higher risk of all-cause-30-day readmission than those discharged in the year 2012 (RR=1.05; p=0.03). Dual eligible patients discharged to skilled nursing facilities had a higher all-cause-30-day readmission risk compared to those discharged home. Length of stay at index admission was not associated with residential location. Patients admitted in the year 2011 were more likely to stay longer than those admitted in 2012 (IRR=1.13; p<.0001).The longer a dual eligible patient stayed during their readmission, the more their cost of readmission. (RR=1.33; p=0.0024). Conclusions: Readmission was neither associated with residential location nor socioeconomic condition. Cost associated with all-cause-30-day readmissions was not associated with residential location of the patients. The study also concludes that length of stay at index admission did not differ with socioeconomic conditions of the areas patients lived. It also concludes that year of discharge was associated with their risk of all-cause-30-day readmission.en_US
dc.typetexten_US
dc.typeElectronic Dissertationen_US
dc.subjectPharmaceutical Sciencesen_US
thesis.degree.namePh.D.en_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.disciplinePharmaceutical Sciencesen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorSlack, Marion K.en_US
dc.contributor.committeememberRoe, Deniseen_US
dc.contributor.committeememberBall, Thomasen_US
dc.contributor.committeememberMalone, Daniel C.en_US
dc.contributor.committeememberSlack, Marion K.en_US
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