Risk of Hospital Readmission among Dual Eligible Population in Arizona: Rural Vs Urban.
AdvisorSlack, Marion K.
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PublisherThe University of Arizona.
RightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
AbstractPurpose: The purpose of this research was to examine and compare readmissions between the rural and urban areas for dual eligible patients in Arizona. The study also examined if living in an area of high socioeconomic status as opposed to living in an area of low socioeconomic status affects patient's risk of all-cause-30-day readmission. Methods: The study used data on dual eligible members who were continuously enrolled in AHCCCS and the University of Arizona Health Network between January 1st, 2011 and November 30th, 2012. The outcomes of interest in this study were risk of all-cause-30-day readmission, length of stay at index admission, and cost of readmission (i.e. amount paid by the University of Arizona Health Network). Log-binomial regression, Poison regression, and gamma regressions were used to model risk of readmission, length of stay at index admission, and cost of readmissions respectively. Results: Readmission of dual eligible patients in this sample was not related to residential location of patients. All-cause-30-day readmission did not differ for rural dual eligible patients and urban dual eligible patients. Readmission of dual eligible patients in this sample was not related to socioeconomic conditions. Dual eligible patients discharged in the year 2011 had a significantly higher risk of all-cause-30-day readmission than those discharged in the year 2012 (RR=1.05; p=0.03). Dual eligible patients discharged to skilled nursing facilities had a higher all-cause-30-day readmission risk compared to those discharged home. Length of stay at index admission was not associated with residential location. Patients admitted in the year 2011 were more likely to stay longer than those admitted in 2012 (IRR=1.13; p<.0001).The longer a dual eligible patient stayed during their readmission, the more their cost of readmission. (RR=1.33; p=0.0024). Conclusions: Readmission was neither associated with residential location nor socioeconomic condition. Cost associated with all-cause-30-day readmissions was not associated with residential location of the patients. The study also concludes that length of stay at index admission did not differ with socioeconomic conditions of the areas patients lived. It also concludes that year of discharge was associated with their risk of all-cause-30-day readmission.
Degree ProgramGraduate College