Risk factors for early hospital readmission in low-income elderly adults

J Am Geriatr Soc. 2014 Mar;62(3):489-94. doi: 10.1111/jgs.12688. Epub 2014 Feb 27.


Objectives: To identify risk factors for early hospital readmission in low-income community-dwelling older adults.

Design: Prospective cohort study.

Setting: University-affiliated urban safety-net healthcare system in Indianapolis, Indiana.

Participants: Community-dwelling adults aged 65 and older with annual income less than 200% of the federal poverty level and enrolled in the Geriatric Resources for Assessment and Care of Elders (GRACE) randomized controlled trial (N = 951).

Measurements: Participant health and functional status at baseline and 6, 12, 18, and 24 months. Early readmission was defined as a repeat hospitalization occurring within 30 days of a prior hospital discharge. Candidate risk factors included sociodemographic characteristics, health and functional status, prior care, lifestyle, and satisfaction with care.

Results: Of 457 index admissions in 328 participants, 85 (19%) were followed by an early readmission. The independent risk factors for early readmission identified according to regression analysis were living alone (odds ratio (OR) = 1.71, 95% confidence interval (CI) = 1.02-2.87), fair or poor satisfaction with primary care physician (OR = 2.12, 95% CI = 1.01-4.46), not having Medicaid (OR = 1.80, 95% CI = 1.05-3.11), receiving a new assistive device in the past 6 months (OR = 2.26, 95% CI = 1.26-4.05), and staying in a nursing home in the past 6 months (OR = 5.08, 95% CI = 1.56-16.53). Age, race, sex, education, and chronic diseases were not associated with early readmission.

Conclusion: A broad range of nonmedical risk factors played a greater role than previously recognized in early hospital readmission of low-income seniors.

Keywords: hospital readmission; low-income seniors; risk factors.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Critical Illness / epidemiology
  • Critical Illness / therapy*
  • Female
  • Follow-Up Studies
  • Geriatric Assessment*
  • Hospital Mortality / trends
  • Humans
  • Incidence
  • Indiana / epidemiology
  • Male
  • Patient Readmission / statistics & numerical data*
  • Poverty*
  • Prospective Studies
  • Risk Factors
  • Time Factors