Featured Research

from universities, journals, and other organizations

'Social environmental factors' affect rehospitalization risk in home healthcare patients

Date:
November 12, 2012
Source:
Wolters Kluwer Health: Lippincott Williams & Wilkins
Summary:
For elderly patients receiving home healthcare after a hospital stay, "social environmental factors" -- particularly care provided by a family member or other informal caregiver -- have a significant impact on the risk of repeated hospital admissions, a study reports.

For elderly patients receiving home healthcare after a hospital stay, "social environmental factors" -- particularly care provided by a family member or other informal caregiver -- have a significant impact on the risk of repeated hospital admissions, reports a study in the October-December issue of Advances in Nursing Science.

The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

"Understanding how social environmental factors contribute to home healthcare patients being rehospitalized would be assist in improving care for patients and in helping agencies deliver more cost-effective care while at the same time managing Medicare spending," according to the report by Hong Tao, RN, PhD, of University of Wisconsin Milwaukee and colleagues.

Social Environmental Factors Affect Functional Abilities…

The study looked at factors affecting the risk of repeated hospital admissions among 1,268 elderly patients receiving home healthcare. Using data from routine, Medicare-required assessments, the researchers focused on the importance of social environmental factors: such as whether the patient lived alone or with others, whether he or she had a primary informal caregiver, and the type and frequency of informal care provided.

Overall, nearly 21 percent of patients in the study were rehospitalized, most within the first 20 days of being discharged from the hospital to home healthcare. Rehospitalizations -- defined as readmission to the hospital within 60 days after being released from the hospital to home care -- are an important indicator of the quality of care.

The study found some significant associations between social environmental factors, and suggested some pathways by which these effects occur. Patients' functional ability -- their ability to take care of themselves -- was influenced by their living arrangements and by the type and frequency of informal care they received.

The greater the difference between the patients' clinical condition and functional status, the greater the risk of rehospitalization. Social environmental factors contributed to the risk of repeated hospital admission by altering the balance between the patient's need for and ability to provide self-care.

…With 'Self-Care Deficit' Leading to Repeat Hospitalizations

Changes in clinical condition placed increased demands on the patient's ability to care for himself or herself, while at the same time making it more difficult to provide self-care. Consistent with a central nursing theory, the resulting "self-care deficit" was linked to an increased risk of rehospitalization.

The amount of care and assistance received from informal caregivers had an important impact on self-care ability and rehospitalization risk. Other patient characteristics linked to self-care deficit included obesity and cognitive (intellectual) ability. Patients living alone were less likely to be rehospitalized -- perhaps because those choosing to live alone were better able to functional independently and care for themselves.

Few previous studies have looked at how social environmental factors in general, and informal caregivers in particular, affect patient outcomes. Rehospitalization is considered a "major adverse event" in home care. "Rehospitalizations are costly and in many cases preventable," Dr Tao and colleagues explain. One recent study found that 20 percent of hospitalized Medicare beneficiaries are readmitted within 30 days, with costs accounting for one-sixth of the total Medicare budget.

Dr Tao and colleagues believe their study has implications for strategies to reduce unnecessary rehospitalizations and improve the quality of home healthcare. "[Our] findings may help home healthcare nurses to recognize those patients who are in need of certain services that may reduce hospitalization, such as those that lack the support of the patient's family or assistance from paid informal caregivers," they write. Patients with good social environmental support are "more likely to have a higher functional ability and thus remain in their homes, the first choice of most patients."

The study also reaffirms the important role of informal caregivers in maintaining home healthcare patients. The authors add, "Informal caregivers are part of the solution in preventing unnecessary hospitalizations and more attention needs to be given to how these caregivers are supported in their roles."


Story Source:

The above story is based on materials provided by Wolters Kluwer Health: Lippincott Williams & Wilkins. Note: Materials may be edited for content and length.


Journal Reference:

  1. Tao, Hong; Ellenbecker, Carol Hall; Chen, Jie; Zhan, Lin; Dalton, Joanne. The Influence of Social Environmental Factors on Rehospitalization Among Patients Receiving Home Health Care Services. Advances in Nursing Science, 2012; 35 (4): 346-358 DOI: 10.1097/ANS.0b013e318271d2ad

Cite This Page:

Wolters Kluwer Health: Lippincott Williams & Wilkins. "'Social environmental factors' affect rehospitalization risk in home healthcare patients." ScienceDaily. ScienceDaily, 12 November 2012. <www.sciencedaily.com/releases/2012/11/121112135331.htm>.
Wolters Kluwer Health: Lippincott Williams & Wilkins. (2012, November 12). 'Social environmental factors' affect rehospitalization risk in home healthcare patients. ScienceDaily. Retrieved April 20, 2014 from www.sciencedaily.com/releases/2012/11/121112135331.htm
Wolters Kluwer Health: Lippincott Williams & Wilkins. "'Social environmental factors' affect rehospitalization risk in home healthcare patients." ScienceDaily. www.sciencedaily.com/releases/2012/11/121112135331.htm (accessed April 20, 2014).

Share This



More Health & Medicine News

Sunday, April 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Nine-Month-Old Baby Can't Open His Mouth

Nine-Month-Old Baby Can't Open His Mouth

Newsy (Apr. 19, 2014) Nine-month-old Wyatt Scott was born with a rare disorder called congenital trismus, which prevents him from opening his mouth. Video provided by Newsy
Powered by NewsLook.com
'Holy Grail' Of Weight Loss? New Find Could Be It

'Holy Grail' Of Weight Loss? New Find Could Be It

Newsy (Apr. 18, 2014) In a potential breakthrough for future obesity treatments, scientists have used MRI scans to pinpoint brown fat in a living adult for the first time. Video provided by Newsy
Powered by NewsLook.com
Little Progress Made In Fighting Food Poisoning, CDC Says

Little Progress Made In Fighting Food Poisoning, CDC Says

Newsy (Apr. 18, 2014) A new report shows rates of two foodborne infections increased in the U.S. in recent years, while salmonella actually dropped 9 percent. Video provided by Newsy
Powered by NewsLook.com
Scientists Create Stem Cells From Adult Skin Cells

Scientists Create Stem Cells From Adult Skin Cells

Newsy (Apr. 17, 2014) The breakthrough could mean a cure for some serious diseases and even the possibility of human cloning, but it's all still a way off. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins