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

Hanzhang Xu, Heather R. Farmer, Bradi B. Granger, Kevin L. Thomas, Eric D. Peterson, Matthew E. Dupre

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)38-48
Number of pages11
JournalCirculation: Cardiovascular Quality and Outcomes
DOIs
StateAccepted/In press - 2021
Externally publishedYes

Keywords

  • cardiovascular disease
  • electronic health records
  • heart failure
  • hospitalization
  • risk

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Perceived Versus Actual Risks of 30-Day Readmission in Patients with Cardiovascular Disease'. Together they form a unique fingerprint.

Cite this