Elder Self-Neglect Is Associated with an Increased Rate of 30-Day Hospital Readmission: Findings from the Chicago Health and Aging Project

被引:43
作者
Dong, XinQi [1 ]
Simon, Melissa A. [2 ]
机构
[1] Rush Univ, Med Ctr, Rush Inst Hlth Aging, Chicago, IL 60612 USA
[2] Northwestern Univ, Med Ctr, Chicago, IL 60611 USA
关键词
Elder self-neglect; 30-Day hospital readmission; Population-based study; SOCIAL SUPPORT; COGNITIVE FUNCTION; COMMUNITY; ABUSE; RISK; MORTALITY; MISTREATMENT; LONELINESS; SERVICES; ADULTS;
D O I
10.1159/000360698
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Background/Aim: Elder self-neglect is associated with increased morbidity and mortality. The objective of this study is to examine the prospective relationship between reported elder self-neglect and the rate of 30-day hospital readmission in a community population. Methods: We conducted a prospective population-based study of community-dwelling older adults who participated in the Chicago Health and Aging Project. Of the 7,219 participants in the Chicago Health and Aging Project, a subset of 1,228 participants was reported to the social services agency for suspected elder self-neglect. The primary predictor was elder self-neglect reported to the social services agency. The outcome of interest was the annual rate of 30-day hospital readmission calculated from the Center for Medicare and Medicaid System hospitalization data from 1993 to 2009. Poisson regression models were used to assess these relationships. Results: The average annual rate of 30-day hospital readmission for those without elder self-neglect was 0.2 (SD 0.7) and for those with reported elder self-neglect 0.9 (SD 2.8). After adjusting for sociodemographic and socioeconomic characteristics, medical comorbidities, cognitive function, physical function, and psychosocial well-being, elders who self-neglect had a significantly higher rate of 30-day hospital readmission (rate ratio 2.50, 95% confidence interval 2.02-3.10). Greater self-neglect severity [mild: parameter estimate (PE) 1.09, standard error (SE) 0.19, p < 0.001; moderate: PE 0.84, SE 0.13, p < 0.001; severe: PE 1.24, SE 0.40, p = 0.002] was associated with increased annual rates of 30-day hospital readmission after considering the same confounders. Interaction term analyses suggest that the significant relationship between selfneglect and 30-day hospital readmission was not moderated by medical conditions, cognitive impairment, physical disability, or psychosocial well-being. Conclusion: Reported elder self-neglect was associated with increased rates of 30-day hospital readmission in this community population. Greater self-neglect severity was associated with a greater increase in the rate of 30-day hospital readmission. (C) 2014 S. Karger AG, Basel
引用
收藏
页码:41 / 50
页数:10
相关论文
共 44 条
[1]   USE OF BRIEF COGNITIVE TESTS TO IDENTIFY INDIVIDUALS IN THE COMMUNITY WITH CLINICALLY DIAGNOSED ALZHEIMERS-DISEASE [J].
ALBERT, M ;
SMITH, LA ;
SCHERR, PA ;
TAYLOR, JO ;
EVANS, DA ;
FUNKENSTEIN, HH .
INTERNATIONAL JOURNAL OF NEUROSCIENCE, 1991, 57 (3-4) :167-178
[2]   Design of the Chicago Health and Aging Project (CHAP) [J].
Bienias, Julia L. ;
Beckett, Laurel A. ;
Bennett, David A. ;
Wilson, Robert S. ;
Evans, Denis A. .
JOURNAL OF ALZHEIMERS DISEASE, 2003, 5 (05) :349-355
[3]   Self-neglect among the elderly: A model based on more than 500 patients seen by a geriatric medicine team [J].
Bitondo, Carmel ;
Goodwin, James S. ;
Pickens-Pace, Sabrina ;
Burnett, Jason ;
Kelly, P. Adam .
AMERICAN JOURNAL OF PUBLIC HEALTH, 2007, 97 (09) :1671-1676
[4]   Interventions to Decrease Hospital Readmissions Keys for Cost-effectiveness [J].
Burke, Robert E. ;
Coleman, Eric A. .
JAMA INTERNAL MEDICINE, 2013, 173 (08) :695-698
[5]   The care transitions intervention - Results of a randomized controlled trial [J].
Coleman, Eric A. ;
Parry, Carla ;
Chalmers, Sandra ;
Min, Sung-joon .
ARCHIVES OF INTERNAL MEDICINE, 2006, 166 (17) :1822-1828
[6]  
CORNONIHUNTLEY J, 1986, NIH PUBL
[7]  
CYBULSKA E, 1986, BRIT J HOSP MED, V36, P21
[8]   Cross-Sectional Study of the Characteristics of Reported Elder Self-Neglect in a Community-Dwelling Population: Findings from a Population-Based Cohort [J].
Dong, Xin-Qi ;
Simon, Melissa ;
Evans, Denis .
GERONTOLOGY, 2010, 56 (03) :325-334
[9]   Is Greater Social Support a Protective Factor against Elder Mistreatment? [J].
Dong, XinQi ;
Simon, Melissa A. .
GERONTOLOGY, 2008, 54 (06) :381-388
[10]   Decision-Making Capacity: The Core of Self-Neglect [J].
Dong, XinQi ;
Gorbien, Martin .
JOURNAL OF ELDER ABUSE & NEGLECT, 2005, 17 (03) :19-36