Original Research
Tuesday, November 14, 2023
08:30 AM–10:00 AM
Abstract
Introduction:
Chronic obstructive pulmonary disease (COPD) and heart failure (HF) are leading causes for hospital readmission. Health-related social needs (HRSNs) are increasingly recognized as contributing factors to readmissions and poor healthcare outcomes. HRSNs interventions are being implemented in various pharmacy settings, yet there is still no standardized approach for identifying patients with HRSNs or addressing them within the care continuum.
Research Question or Hypothesis:
What is the relationship between HRSNs and healthcare utilization (HCU) following hospitalization among older adults with COPD or HF?
Study Design:
Retrospective cohort study between January 2019 to December 2020 utilizing the Western New York health information exchange database.
Methods:
Study eligibility included patients aged =65 years, COPD and/or HF diagnosis based on CMS readmission measures methodology, and an unplanned hospitalization. HRSNs were identified using diagnostic ICD-10-Z-codes (Z55–Z65 & 75) and were evaluated dichotomously as present or not. The three primary utilization outcomes at 30 days post-discharge included: (1) ED visits; (2) all-cause readmissions; and (3) combined HCU defined as having either (1) or (2). Multivariable logistic regression models were used to evaluate the relationship between HRSNs and utilization outcomes (SAS, version 9.4).
Results:
There were 19,536 patients who met study eligibility. 784 (5%) were identified with at least one ICD-10-Z-code. Problems related to medical facilities and other health care (Z75) was most frequently documented. Adjusted models showed that HRSNs were associated with 42% (aOR, 1.42, 95% CI, 1.17-1.73, p=0.0004), 17% (aOR, 1.17, 95% CI, 0.97-1.40, p=0.097), and 20% (aOR, 1.2 95% CI, 1.02-1.41, p=0.03) increased odds for ED visits, all cause readmissions, and combined HCU 30 days post-discharge, respectively.
Conclusion:
HRSNs are associated with increased odds for ED visits, readmissions, and combined HCU 30 days following hospitalization among older adults with COPD or HF. Efforts to develop innovative team-based care transition interventions in collaboration with pharmacy are needed to address HRSNs.
Presenting Author
Durdana Iqbal PharmDUniversity at Buffalo
Authors
Rongzhen Lu PharmD Candidate
University at Buffalo
David M. Jacobs PharmD, PhD
University at Buffalo School of Pharmacy and Pharmaceutical Sciences
Christopher J. Daly PharmD, MBA, BCACP
University at Buffalo School of Pharmacy and Pharmaceutical Sciences
Steven Feuerstein MS
University at Buffalo School of Pharmacy and Pharmaceutical Sciences
Robert G. Wahler Jr. PharmD
University at Buffalo School of Pharmacy and Pharmaceutical Sciences
Ranjit Singh MB BChir, MBA
University at Buffalo
Jennifer Stoll PhD
University at Buffalo