A state-level analysis of macro-level factors associated with hospital readmissions

Reginald A. Silver (), Joumana Haidar () and Chandrika Johnson ()
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Reginald A. Silver: University of North Carolina at Charlotte Belk College of Business
Joumana Haidar: Health University of North Carolina at Chapel Hill
Chandrika Johnson: Fayetteville State University

The European Journal of Health Economics, 2024, vol. 25, issue 7, No 8, 1205-1215

Abstract: Abstract Investigation of the factors that contribute to hospital readmissions has focused largely on individual level factors. We extend the knowledge base by exploring macrolevel factors that may contribute to readmissions. We point to environmental, behavioral, and socioeconomic factors that are emerging as correlates to readmissions. Data were taken from publicly available reports provided by multiple agencies. Partial Least Squares–Structural Equation Modeling was used to test the association between economic stability and environmental factors on opioid use which was in turn tested for a direct association with hospital readmissions. We also tested whether hospital access as measured by the proportion of people per hospital moderates the relationship between opioid use and hospital readmissions. We found significant associations between Negative Economic Factors and Opioid Use, between Environmental Factors and Opioid Use, and between Opioid Use and Hospital Readmissions. We found that Hospital Access positively moderates the relationship between Opioid Use and Readmissions. A priori assumptions about factors that influence hospital readmissions must extend beyond just individualistic factors and must incorporate a holistic approach that also considers the impact of macrolevel environmental factors.

Keywords: Opioid use; Hospital readmissions; Environmental factors (search for similar items in EconPapers)
JEL-codes: H75 I1 (search for similar items in EconPapers)
Date: 2024
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DOI: 10.1007/s10198-023-01661-z

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