MEDICARE READMISSIONS AND DISCHARGE PLANNING: IMPLICATIONS FOR NURSING ADMINISTRATORS.
Contributors: University of Rochester.
Published: 1988
Number of pages: 100
Subjects: Health Sciences, Nursing.
Description: The purpose of this study was to examine factors influencing readmission of the elderly to acute care hospitals. The specific areas examined were personal characteristics and elements of discharge planning. It was felt that if specific personal characteristics or specific elements of discharge planning that influenced readmissions could be identified efforts could be made to decrease these readmissions.

The sample for this study was 198 subjects, consisting of 101 (51%) in Group A (those not readmitted within 90 days to an acute care hospital) and 97 (49%) in Group B (those readmitted within 90 days). Data on personal characteristics of the subjects were collected for age, sex, type of health insurance, race, availability of significant other, and medical diagnosis at the time of discharge (diagnostic related categories). Data collected on discharge planning included involvement of patients/significant other in the discharge plans, and patient teaching in the areas of medication and diet. All data were gathered by a retrospective chart review from randomly selected cases. Data were analyzed with chi-square and Fisher's Exact Test using cross-tabulation and elaboration paradigm procedures.

The results of the study revealed the following findings. Patients not taught the time to take their medications, or what medications were needed, were more likely to be readmitted than those that had been taught. In the examination of the relationship between medication teaching and readmission controlling for personal characteristics, males, and those in the age group 75-79, were more likely to be readmitted. White patients, and those with significant others to assist them, and those that had private supplemental health insurance in addition to Medicare were more likely to be readmitted. In addition, there was a 19% higher incidence of nursing home patients being readmitted.

While there were few specific conclusions from these findings, some indications of need for further research were identified. Nursing administrators need to explore ways to improve nurses' understanding and responsibility for patient teaching. In addition examination of new approaches to teach students and practitioners their role in discharge planning may decrease readmissions of the elderly to acute care hospitals. (Abstract shortened with permission of author.).
Notes: Source: Dissertation Abstracts International, Volume: 49-09, Section: B, page: 3675.

Thesis (ED.D.)--THE UNIVERSITY OF ROCHESTER, 1988.

School code: 0188.