Behavioral, Cognitive, and Functional Risk Factors for Repeat Hospital Episodes Among Medicare-Medicaid Dually Eligible Adults Receiving Long-Term Services and Supports.

IF 2.2 3区医学 Q2 GERONTOLOGY

Journal of Applied Gerontology Pub Date : 2024-09-26 DOI:10.1177/07334648241286608

Oludolapo Fakeye, Prashant Rana, Fei Han, Morgan Henderson, Ian Stockwell

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引用次数: 0

Abstract

Repeat hospitalizations adversely impact the well-being of adults dually eligible for Medicare and Medicaid in the United States. This study aimed to identify behavioral, cognitive, and functional characteristics associated with the risk of a repeat hospital episode (HE) among the statewide population of dually eligible adults in Maryland receiving long-term services and supports prior to an HE between July 2018 and May 2020. The odds of experiencing a repeat HE within 30 days after an initial HE were positively associated with reporting difficulty with hearing (adjusted odds ratio, AOR: 1.10 [95% confidence interval: 1.02-1.19]), being easily distractible (AOR: 1.09 [1.00-1.18]), being self-injurious (AOR: 1.33 [1.09-1.63]), and exhibiting verbal abuse (AOR: 1.15 [1.02-1.30]). Conversely, displaying inappropriate public behavior (AOR: 0.62 [0.42-0.92]) and being dependent for eating (AOR: 0.91 [0.83-0.99]) or bathing (AOR: 0.79 [0.67-0.92]) were associated with reduced odds of a repeat HE. We also observed differences in the magnitude and direction of these associations among adults 65 years of age or older relative to younger counterparts.

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接受长期服务和支持的符合医疗保险和医疗补助双重资格的成年人重复住院的行为、认知和功能风险因素。

重复住院对美国符合医疗保险和医疗补助双重资格的成年人的福祉造成了不利影响。本研究旨在确定在 2018 年 7 月至 2020 年 5 月期间，马里兰州全州范围内接受长期服务和支持的符合双重资格的成年人中，与重复住院风险（HE）相关的行为、认知和功能特征。初次住院后 30 天内再次住院的几率与报告听力困难（调整后的几率比，AOR：1.10 [95% 置信区间：1.02-1.19]）、容易分心（AOR：1.09 [1.00-1.18]）、自伤（AOR：1.33 [1.09-1.63]）和表现出辱骂（AOR：1.15 [1.02-1.30]）呈正相关。相反，表现出不恰当的公共行为（AOR：0.62 [0.42-0.92]）和依赖他人进食（AOR：0.91 [0.83-0.99]）或洗澡（AOR：0.79 [0.67-0.92]）与重复发生 HE 的几率降低有关。我们还观察到，在 65 岁或以上的成年人中，这些关联的程度和方向与年轻成年人有所不同。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Applied Gerontology GERONTOLOGY-

CiteScore

5.10

自引率

13.30%

发文量

202

期刊介绍： The Journal of Applied Gerontology (JAG) is the official journal of the Southern Gerontological Society. It features articles that focus on research applications intended to improve the quality of life of older persons or to enhance our understanding of age-related issues that will eventually lead to such outcomes. We construe application broadly and encourage contributions across a range of applications toward those foci, including interventions, methodology, policy, and theory. Manuscripts from all disciplines represented in gerontology are welcome. Because the circulation and intended audience of JAG is global, contributions from international authors are encouraged.