Profile of Postdischarge Rehospitalizations and Acute Care Visits for Seven Patient Groups

Authors

  • Dorothy Brooten Ph.D., FAAN,

    Corresponding author
    1. Dorothy Brooten is Professor and Associate Dean for Research and Graduate Studies at the Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio.
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  • Mary Naylor Ph.D., FAAN,

    1. Mary Naylor, Linda Brown, Ruth York, Andrea Hollingsworth, and Barbara Jacobsen are with the University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania.
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  • Linda Brown Ph.D., FAAN,

    1. Mary Naylor, Linda Brown, Ruth York, Andrea Hollingsworth, and Barbara Jacobsen are with the University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania.
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  • Ruth York Ph.D., FAAN,

    1. Mary Naylor, Linda Brown, Ruth York, Andrea Hollingsworth, and Barbara Jacobsen are with the University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania.
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  • Andrea Hollingsworth Ph.D.,

    1. Mary Naylor, Linda Brown, Ruth York, Andrea Hollingsworth, and Barbara Jacobsen are with the University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania.
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  • Susan Cohen Ph.D., FAAN,

    1. Susan Cohen is with Yale University School of Nursing, New Haven, Connecticut.
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  • Marianne Roncoli Ph.D.,

    1. Marianne Roncoli is with New York University School of Nursing, New York, New York.
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  • Barbara Jacobsen M.S.Ed.

    1. Mary Naylor, Linda Brown, Ruth York, Andrea Hollingsworth, and Barbara Jacobsen are with the University of Pennsylvania, School of Nursing, Philadelphia, Pennsylvania.
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Address correspondence to Dorothy Brooten, Ph.D., FAAN, Associate Dean for Research and Graduate Studies, Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106.

Abstract

Abstract The study's purpose was to examine postdischarge rehospitalizations and acute care visits in seven high risk, high volume, high-cost patient groups. Subjects were drawn from an urban tertiary teaching hospital. The total sample (N= 764) consisted of seven patient groups (drawn from five randomized clinical trials): very low birthweight (VLBW) infants (n= 79); women post-unplanned cesarean birth (n= 122) and their infants (n= 123); pregnant women with diabetes (n= 55); women post-hysterectomy surgery (n= 109); and elderly with medical cardiac Diagnostic Related Groups (DRGs) (n= 142) and elderly with surgical cardiac DRGs (n= 134). The VLBW infant and pregnant diabetic groups were predominantly African American, the elderly and hysterectomy groups predominantly Caucasian, and the cesarean group almost equally distributed. The lowest rate of rehospitalization (2%) occurred in the cesarean group, the highest (35%) in the pregnant diabetics. In four groups (cesarean and infants, hysterectomy and surgical elderly), 60%-100% of the rehospitalizations occurred within 4 weeks of discharge. Subjects requiring acute care visits ranged from 13% (hysterectomy) to 82% (VLBW infants). Acute care visits demonstrated greater distribution throughout the follow-up periods but also tended to concentrate in the first 4 weeks postdischarge.

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