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

Jamie M. Smith, Haiqun Lin, Charlotte Thomas-Hawkins, Jennifer Tsui and Olga F. Jarrín
Additional contact information
Jamie M. Smith: College of Nursing, Thomas Jefferson University, Philadelphia, PA 19107, USA
Haiqun Lin: School of Nursing, Rutgers, The State University of New Jersey, Newark, NJ 07108, 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

IJERPH, 2021, vol. 18, issue 11, 1-13

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.

Keywords: chronic conditions; diabetes; older adults; race or ethnicity; social determinants of health; inequalities or inequities; policy; health care access; home health care; rehospitalization (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/18/11/5623/pdf (application/pdf)
https://www.mdpi.com/1660-4601/18/11/5623/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:18:y:2021:i:11:p:5623-:d:561495

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().