Home health care after discharge is associated with lower readmission rates for patients with acute myocardial infarction

Sheikh, M. A., Ngendahimana, D., Deo, S. V. , Raza, S., Altarabsheh, S. E., Reed, G. W., Kalra, A., Cmolik, B., Kapadia, S. and Eagle, K. A. (2021) Home health care after discharge is associated with lower readmission rates for patients with acute myocardial infarction. Coronary Artery Disease, 32(6), pp. 481-488. (doi: 10.1097/MCA.0000000000001000) (PMID:33471476)

Abstract

Objective: We studied the utilization of home health care (HHC) among acute myocardial infarction (AMI) patients, impact of HHC on and predictors of 30-day readmission. Methods: We queried the National Readmission Database (NRD) from 2012 to 2014identify patients with AMI discharged home with (HHC+) and without HHC (HHC-). Linkage provided in the data identified patients who had 30-day readmission, our primary end-point. The probability for each patient to receive HHC was calculated by a multivariable logistic regression. Average treatment of treated weights were derived from propensity scores. Weight-adjusted logistic regression was used to determine impact of HHC on readmission. Results: A total of 406 237 patients with AMI were discharged home. Patients in the HHC+ cohort (38 215 patients, 9.4%) were older (mean age 77 vs. 60 years P < 0.001), more likely women (53 vs. 26%, P < 0.001), have heart failure (5 vs. 0.5%, P < 0.001), chronic kidney disease (26 vs. 6%, P < 0.001) and diabetes (35 vs. 26%, P < 0.001). Patients readmitted within 30-days were older with higher rates of diabetes (RR = 1.4, 95% CI: 1.37-1.48) and heart failure (RR = 5.8, 95% CI: 5.5-6.2). Unadjusted 30-day readmission rates were 21 and 8% for HHC+ and HHC- patients, respectively. After adjustment, readmission was lower with HHC (21 vs. 24%, RR = 0.89, 95% CI: 0.82-0.96; P < 0.001). Conclusion: In the United States, AMI patients receiving HHC are older and have more comorbidities; however, HHC was associated with a lower 30-day readmission rate.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Deo, Salil
• Authors: Sheikh, M. A., Ngendahimana, D., Deo, S. V., Raza, S., Altarabsheh, S. E., Reed, G. W., Kalra, A., Cmolik, B., Kapadia, S., and Eagle, K. A.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: Coronary Artery Disease
• Publisher: Lippincott, Williams & Wilkins
• ISSN: 0954-6928
• ISSN (Online): 1473-5830
• Published Online: 18 January 2021