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. 2022 Jun 22:9:23333928221104644.
doi: 10.1177/23333928221104644. eCollection 2022 Jan-Dec.

Association of Early and Late Hospital Readmissions with a Novel Housing-Based Socioeconomic Measure

Kaitlyn I Zurek  1 , Christopher L Boswell  2 , Nathanial E Miller  2 , Jennifer L Pecina  2 , Matthew D Decker  2 , Chung I Wi  3 , Gregory M Garrison  2
Affiliations

Association of Early and Late Hospital Readmissions with a Novel Housing-Based Socioeconomic Measure

Kaitlyn I Zurek et al. Health Serv Res Manag Epidemiol. .

Abstract

Background: While socioeconomic status has been linked to hospital readmissions for several conditions, reliable measures of individual socioeconomic status are often not available. HOUSES, a new measure of individual socioeconomic status based upon objective public data about one's housing unit, is inversely associated with overall hospitalization rate but it has not been studied with respect to readmissions.

Purpose: To determine if patients in the lowest HOUSES quartile are more likely to be readmitted within 30 days (short-term) and 180 days (long-term).

Methods: A retrospective cohort study of 11 993 patients having 21 633 admissions was conducted using generalized linear mixed-effects models.

Results: HOUSES quartile did not show any significant association with early readmission. However, when compared to the lowest HOUSES quartile, the second quartile (OR = 0.90, 95%CI 0.83-0.98) and the third quartile (OR = 0.91, 95%CI 0.83-0.99) were associated with lower odds of late readmission while the highest quartile (OR = 0.91, 95%CI 0.82-1.01) was not statistically different.

Conclusion: HOUSES was associated with late readmission, but not early readmission. This may be because early readmissions are influenced by medical conditions and hospital care while late readmissions are influenced by ambulatory care and home-based factors. Since HOUSES relies on public county assessor data, it is generally available and may be used to focus interventions on those at highest risk for late readmission.

Keywords: health outcomes; hospital readmission; managerial epidemiology; medical informatics; social determents of health.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Cohort development.
Figure 2.
Figure 2.
Histogram of HOUSES scores.
Figure 3.
Figure 3.
Multivariate model for readmission or death within 30 days.
Figure 4.
Figure 4.
Multivariate model for readmission or death within 180 days.
See this image and copyright information in PMC

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