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. 2021 Jan;14(1):e006586.
doi: 10.1161/CIRCOUTCOMES.120.006586. Epub 2021 Jan 12.

Perceived Versus Actual Risks of 30-Day Readmission in Patients With Cardiovascular Disease

Hanzhang Xu  1   2   3 , Heather R Farmer  4 , Bradi B Granger  2 , Kevin L Thomas  5   6 , Eric D Peterson  5   7 , Matthew E Dupre  3   5   8   9
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Perceived Versus Actual Risks of 30-Day Readmission in Patients With Cardiovascular Disease

Hanzhang Xu et al. Circ Cardiovasc Qual Outcomes. 2021 Jan.

Abstract

Background: Cardiovascular disease (CVD) is the leading cause of hospitalization in the United States, and patients with CVD are at a high risk of readmission after discharge. We examined whether patients' perceived risk of readmission at discharge was associated with actual 30-day readmissions in patients hospitalized with CVD.

Methods: We recruited 730 patients from the Duke Heart Center who were admitted for treatment of CVD between January 1, 2015, and August 31, 2017. A standardized survey was linked with electronic health records to ascertain patients' perceived risk of readmission, and other sociodemographic, psychosocial, behavioral, and clinical data before discharge. All-cause readmission within 30 days after discharge was examined.

Results: Nearly 1-in-3 patients perceived a high risk of readmission at index admission and those who perceived a high risk had significantly more readmissions within 30 days than patients who perceived low risks of readmission (23.6% versus 15.8%, P=0.016). Among those who perceived a high risk of readmission, non-White patients (odds ratio [OR], 2.07 [95% CI, 1.28-3.36]), those with poor self-rated health (OR, 2.30 [95% CI, 1.38-3.85]), difficulty accessing care (OR, 2.72 [95% CI, 1.24-6.00]), and prior hospitalizations in the past year (OR, 2.13 [95% CI, 1.21-3.74]) were more likely to be readmitted. Among those who perceived a low risk of readmission, patients who were widowed (OR, 2.69 [95% CI, 1.60-4.51]) and reported difficulty accessing care (OR, 1.89 [95% CI, 1.07-3.33]) were more likely to be readmitted.

Conclusions: Patients who perceived a high risk of readmission had a higher rate of 30-day readmission than patients who perceived a low risk. These findings have important implications for identifying CVD patients at a high risk of 30-day readmission and targeting the factors associated with perceived and actual risks of readmission.

Keywords: cardiovascular disease; electronic health records; heart failure; hospitalization; risk.

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Figure 1.
Figure 1.
Study Participants from the Duke Heart Center
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