{"id":6490,"date":"2016-05-19T00:00:00","date_gmt":"2016-05-19T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/hospital-readmissions-in-a-community-based-sample-of-homeless-adults-a-matched-cohort-study\/"},"modified":"2023-06-14T19:35:49","modified_gmt":"2023-06-14T23:35:49","slug":"hospital-readmissions-in-a-community-based-sample-of-homeless-adults-a-matched-cohort-study","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/hospital-readmissions-in-a-community-based-sample-of-homeless-adults-a-matched-cohort-study\/","title":{"rendered":"Hospital readmissions in a community-based sample of homeless adults: a matched-cohort study"},"content":{"rendered":"<p><strong>Background <\/strong>&#x2014; Hospital readmission rates are a widely used quality indicator that may be elevated in disadvantaged populations.<\/p>\n<p><strong>Objective<\/strong> &#x2014; The objective of this study was to compare the hospital readmission rate among individuals experiencing homelessness with that of a low-income matched control group, and to identify risk factors associated with readmission within the group experiencing homelessness. <\/p>\n<p><strong>Design<\/strong> &#x2014; We conducted a 1:1 matched cohort study comparing 30-day hospital readmission rates between homeless patients and low-income controls matched on age, sex and primary reason for admission. Multivariate analyses using generalized estimating equations were used to assess risk factors associated with 30-day readmission in the homeless cohort.<\/p>\n<p><strong>Participants<\/strong> &#x2014; This study examined a cohort of 1,165 homeless adults recruited at homeless shelters and meal programs in Toronto, Ontario, between December 6, 2004, and December 20, 2005. <\/p>\n<p><strong>Main Measures<\/strong> &#x2014; The primary outcome was the occurrence of an unplanned medical or surgical readmission within 30 days of discharge from hospital. <\/p>\n<p><strong>Key Results<\/strong> &#x2014; Between December 6<sup>th<\/sup>, 2004 and March 31<sup>st<\/sup>, 2009, homeless participants (N= 203) had 478 hospitalizations and a 30-day readmission rate of 22.2%, compared to 300 hospitalizations and a readmission rate of 7.0% among matched controls (OR= 3.79, 95% CI 1.93-7.39). In the homeless cohort, having a primary care physician (OR=2.65, 95% CI 1.05-6.73) and leaving against medical advice (OR=1.96, 95% CI 0.99-3.86) were associated with an increased risk of 30-day readmission. <\/p>\n<p><strong>Conclusions<\/strong> &#x2014; Homeless patients had nearly four times the odds of being readmitted within 30-days as compared to low-income controls matched on age, sex and primary reason for admission to hospital. Further research is needed to evaluate interventions to reduce readmissions among this patient population.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background &#x2014; Hospital readmission rates are a widely used quality indicator that may be elevated in disadvantaged populations. Objective &#x2014; The objective of this study was to compare the hospital readmission rate among individuals experiencing homelessness with that of a low-income matched control group, and to identify risk factors associated with readmission within the group [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[24,20],"migration-helper-qa-sample-set":[],"class_list":["post-6490","journal_article","type-journal_article","status-publish","hentry","topic-acute-and-emergency-services","topic-health-and-health-care-inequality"],"acf":{"citation":"Saab D, Nisenbaum R, Dhalla I, Hwang SW. <em>J Gen Intern Med<\/em>. 2016; 31(9):1011-8. Epub 2016 May 19.","source_url":"https:\/\/link.springer.com\/article\/10.1007%2Fs11606-016-3680-8","ices_scientist":[1213,1271],"site":[6733],"research_program":[6746],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"131D2C41-90A1-4D8D-AB1B-5027D9AAF271","sitecore_item_name":"Hospital-readmissions-in-a-community-based-sample-of-homeless-adults-a-matched-cohort-study","sitecore_field_values":"{\n  \"__Valid from\": \"20170814T111553\",\n  \"Title\": \"Hospital readmissions in a community-based sample of homeless adults: a matched-cohort study\",\n  \"Short title\": \"Hospital readmissions in a\",\n  \"Summary\": \"This study compared the hospital readmission rate among individuals experiencing homelessness with that of a low-income matched control group. \",\n  \"Citation\": \"<p>Saab D, Nisenbaum R, Dhalla I, Hwang SW. <em>J Gen Intern Med<\/em>. 2016; 31(9):1011-8. Epub 2016 May 19.<\/p>\",\n  \"Abstract\": \"<p><strong>Background <\/strong>&mdash; Hospital readmission rates are a widely used quality indicator that may be elevated in disadvantaged populations.<\/p>n<p><strong>Objective<\/strong> &mdash; The objective of this study was to compare the hospital readmission rate among individuals experiencing homelessness with that of a low-income matched control group, and to identify risk factors associated with readmission within the group experiencing homelessness. <\/p>n<p><strong>Design<\/strong> &mdash; We conducted a 1:1 matched cohort study comparing 30-day hospital readmission rates between homeless patients and low-income controls matched on age, sex and primary reason for admission. Multivariate analyses using generalized estimating equations were used to assess risk factors associated with 30-day readmission in the homeless cohort.<\/p>n<p><strong>Participants<\/strong> &mdash; This study examined a cohort of 1,165 homeless adults recruited at homeless shelters and meal programs in Toronto, Ontario, between December 6, 2004, and December 20, 2005. <\/p>n<p><strong>Main Measures<\/strong> &mdash; The primary outcome was the occurrence of an unplanned medical or surgical readmission within 30 days of discharge from hospital. <\/p>n<p><strong>Key Results<\/strong> &mdash; Between December 6<sup>th<\/sup>, 2004 and March 31<sup>st<\/sup>, 2009, homeless participants (N= 203) had 478 hospitalizations and a 30-day readmission rate of 22.2%, compared to 300 hospitalizations and a readmission rate of 7.0% among matched controls (OR= 3.79, 95% CI 1.93-7.39). In the homeless cohort, having a primary care physician (OR=2.65, 95% CI 1.05-6.73) and leaving against medical advice (OR=1.96, 95% CI 0.99-3.86) were associated with an increased risk of 30-day readmission. <\/p>n<p><strong>Conclusions<\/strong> &mdash; Homeless patients had nearly four times the odds of being readmitted within 30-days as compared to low-income controls matched on age, sex and primary reason for admission to hospital. Further research is needed to evaluate interventions to reduce readmissions among this patient population.<\/p>n<p><a href=\"https:\/\/link.springer.com\/article\/10.1007%2Fs11606-016-3680-8\" title=\"opens external link\">View full text<\/a><\/p>\",\n  \"Keywords\": \"{404E8236-468F-4DA1-8BA1-F405AC36275E}|{E93E0287-ACCB-4952-BB98-00EF52815525}\",\n  \"Research Programs\": \"{CFE36C89-C969-4C23-B5E4-1BA9E5BDC273}|{5B1AF319-EC9B-4BF0-A9CD-D066ABE49D71}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{C3A1DE68-838D-4F81-AA49-35368583A9A8}|{0C9AB207-93FF-44DC-91F0-579DF3D39255}\",\n  \"Posted Date\": \"20160519T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2016\/January\/Hospital-readmissions-in-a-community-based-sample-of-homeless-adults-a-matched-cohort-study"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Hospital readmissions in a community-based sample of homeless adults: a matched-cohort study<\/title>\n<meta name=\"description\" content=\"Background &#x2014; Hospital readmission rates are a widely used quality indicator that may be elevated in disadvantaged populations. 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