Psychosocial Factors and Hospital Readmission Status of Older Persons with Cardiovascular Disease

Abstract

One hundred twenty-one (121) patients 55 years and older, having cardiovascular disease, were followed for 90 days to identify factors that might be used as predictors for hospital readmission. An initial step was to determine which health status or psychosocial measures would best discriminate between two readmission groups (readmission vs. no readmission). Four factors were univariately significant: physical health, personal adjustment, happiness, and number of secondary disorders. At the end of the specified follow-up period, 71 persons (58.7%) had experienced at least one unplanned readmission. Specifically, persons reporting a positive affect about their present circumstances, and enhanced optimism about their future, were less likely to be readmitted. Further, patients who were readmitted reported worse physical health before their readmission and had a greater number of secondary disorders. It is recommended that these factors be used in a multiple discriminant predictive model in future studies to detect their potential for predicting hospital readmission. If identification of at risk characteristics for repeated admissions among predictable high cost groups can be achieved, these data can supply rehabilitation professionals with the necessary information needed for the design of comprehensive and intensive cost-effective interventions in cardiac rehabilitation. Clinical applications for the rehabilitation counselor are discussed with respect to intervention considerations and the community reintegration of the older person from the hospital to their home and other independent living settings.