Postdischarge Environmental and Socioeconomic Factors and the Likelihood of Early Hospital Readmission Among Community-Dwelling Medicare Beneficiaries

Older Americans are significantly more likely to be readmitted to a hospital quickly if they live alone, lack self-management skills, have limited education, or do not receive the help they need for daily living functions, according to analysis of recent Medicare data.

Early hospital readmissions comprise almost 10 percent of Medicare inpatient hospital expenditures. This study looked at 2001 and 2002 nationwide Medicare data to determine whether certain post-discharge and socioeconomic factors could help identify patients most at-risk for early readmission. Patients included in the national sample all lived in the general community and were hospitalized, discharged home and survived at least one year.

Key Findings:

  • 15 percent, or 202, of the analytic sample of 1,351 hospitalized beneficiaries were readmitted within 60 days.
  • Living alone increased the odds of early readmission by 50 percent.
  • Having unmet functional needs increased the odds of early readmission by 48 percent.
  • Lacking self-management skills increased the odds by 44 percent.
  • Not having a high school diploma increased the odds by 42 percent.
  • Low income, age, minority status and gender did not correlate to significantly greater odds of early readmission, although the authors advise caution due to limitations in their data and analysis and because these findings do not agree with earlier research.

Armed with these insights, professionals may be able to identify individuals at-risk for early readmission and create better post-discharge care plans to improve transitional care and keep patients out of the hospital. Additional avenues for research include studying interventions that address possible underlying patient needs reflected in these factors.