Socio-ecological risk factors of hospital readmission in an underserved population.

Hospital readmissions are costly, preventable, and currently a significant focus of healthcare reform. The Hospital Readmissions Reduction Program, an Affordable Care Act initiative, financially penalizes hospitals for excessive readmissions based on the premise that it will incentivize hospitals and physicians to provide higher quality patient care. The purpose of this study was to compare socio-ecological risk factors of hospital readmission among 30, 60, and 90 day readmission groups in an underserved population. A retrospective secondary data analysis was conducted using electronic patient medical records from twelve central Texas acute care facilities that serve patients living below 200% of the federal poverty guideline. Eight factors were analyzed as correlates of hospital readmission among 30, 60, and 90 day readmissions groups. A longer time period in days between the initial hospital encounter and the follow-up visit as well as being of the female sex were associated with 60 or 90 day readmission compared to 30 day readmission. In the dawn of policy reform targeted at reducing hospital readmissions, factors that determine readmission risk must be examined. Clarification of
the relationships between risk factors and readmission groups can help inform future policy and practice.