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학술저널
저자정보
신진영 (Department of Family Medicine Konkuk University Medical Center Konkuk University School of Medicine) Seol-Heui Han (Research Institute on Healthy Aging Konkuk University Medical Center Seoul Korea) Jaekyung Choi (Department of Family Medicine Konkuk University Medical Center Konkuk University School of Medicin) Yoon-Sook Kim (Research Institute on Healthy Aging Konkuk University Medical Center Seoul Korea) Jongmin Lee (Research Institute on Healthy Aging Konkuk University Medical Center Seoul Korea)
저널정보
대한노인병학회 Annals of geriatric medicine and research Annals of geriatric medicine and research Vol.24 No.2
발행연도
2020.1
수록면
83 - 90 (8page)

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Background: Given the association between geriatric syndrome and hospital readmission, we evaluated the suitability of geriatric syndrome screening for care (GSC) in identifying readmission risk and suggested the appropriate time for GSC. Methods: GSC considering cognitive impairment, depression, polypharmacy (five or more medications), functional mobility, dysphagia, malnutrition, pain, and incontinence was performed among 2,663 general ward inpatients aged 65 years or older within 48 hours after admission and again before discharge between November 2016 and October 2017. Each patient’s history of falls, pressure ulcers, potentially inappropriate medication use, and delirium was assessed at admission. Patients were divided into two groups on the basis of readmission within 1 year after the first admission. According to the screening period (at admission and before discharge) and in-hospital decline, we applied receiver operating characteristic curve analysis to compare the prevalence of clinical concerns between the readmission and no-readmission groups. We also used multiple logistic regression analysis to evaluate the risk of readmission according to the presence of geriatric syndrome and clinical outcomes. Results: The 782 readmitted patients (29.4%) showed a higher rate of poor GSC than those who were not readmitted. Polypharmacy at admission was significantly correlated with readmission risk (area under the receiver operating characteristic curve=0.602). Fall history (odds ratio [OR]=4.36; 95% confidence interval [CI], 2.36–8.05), urinary incontinence (OR=4.21; 95% CI, 3.28–5.39), and depressive mood (OR=3.88; 95% CI, 2.69–5.59) at admission were risk factors for readmission. Conclusion: GSC at admission was associated with readmission risk compared with GSC before discharge or monitoring for in-hospital decline.
#Patient readmission #Aged #Geriatric assessment #Risk assessment

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참고문헌 (32)

참고문헌 신청
Goldstein JN / 2016 / Is the care transitions measure associated with readmission risk? Analysis from a single academic center / J Gen Intern Med 31:732~738 google schola Boozary AS / 2015 / The Medicare hospital readmissions reduction program : time for reform / JAMA 314:347~348 google schola Robinson S / 2012 / Readmission risk factors after hospital discharge among the elderly / Popul Health Manag 15:338~351 google schola Yu-Chun Wang / 2019 / Post-Acute Care as a Key Component in a Healthcare System for Older Adults / Annals of geriatric medicine and research 23(2):54~62 dbpia Weinreich M / 2016 / Predicting the risk of readmission in pneumonia : a systematic review of model performance / Ann Am Thorac Soc 13:1607~1614 google schola

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