Skip to Main Content
 

Global Search Box

 
 
 
 

Files

File List


Sean McIntyre 4-18-19 edit 2.pdf (744.92 KB)

ETD Abstract Container

Abstract Header

Determining the Effect of Depression on Geriatric Heart Failure Readmissions: A Retrospective Cohort Study

McIntyre, Sean Michael
http://rave.ohiolink.edu/etdc/view?acc_num=osu1555451811558217

Abstract Details

2019, Master of Science, Ohio State University, Allied Medicine.
Background: Healthcare institutions are facing higher care standards from insurers such as Medicare due to rampant cost increases. A focus of the Patient Protection and Affordable Care Act of 2010 is controlling costs while improving patient care, and an above average readmission rate for patients is seen as a failure to coordinate and perform standardized care. Healthcare institutions are given reduced payments by Medicare when excess readmissions occur. Independently, heart failure, depression, and geriatric status all have a relationship to increased readmission rates. The purpose of this study was to evaluate whether individuals already identified as geriatric heart failure patients at an academic heart hospital in the Midwest are at are at higher risk for readmission if they have a depression diagnosis. Design and methods: In this study, the independent variable for the geriatric heart failure patient sample was depression. A retrospective cohort study was used to evaluate heart hospital patient discharges and 30-day readmission rates from two select hospital services for the period July 1, 2012 through June 30, 2018. The data were also used to assess geriatric heart failure readmission risk’s association with socioeconomic status using dual eligible or Medicaid insurance. County Health Rankings were compared between depressed and non-depressed patients to examine if depressed patients lived in counties with poor health factors and outcomes. Deidentified patient data were used from this academic medical center’s Information Warehouse. Results: In the heart failure cohort, 129 patients had readmissions during the study period and 331 did not have a readmission. Among the readmitted patients, 12.1% (n = 15) had a depression diagnosis, but it was not more prevalent in this group than the not readmitted patients (p = .164, OR = 1.61). County Health Rankings were not associated with rates of depression, but the proportion of dual eligible and Medicaid patients among the readmitted patients compared to not readmitted was significant (p = .015, OR = 3.01). Heart hospital medicine had 137 patients readmitted and a rate of depression of 8.03% (n = 11). Of the 474 patients not readmitted, 8.02% (n = 38) had a depression diagnosis. There was not a significant difference in the proportion of depressed patients in this cohort (p = .996, OR = 1.00). County Health Rankings did not have an association with depression, and Medicaid or dual eligible insurance was not associated with higher readmission rates (p = .908, OR =0.96). Conclusion This study found limited evidence of depression having a significant relationship to geriatric heart failure readmissions at this academic heart hospital in the Midwest. The prevalence of depression diagnosis in all groups was lower than expected, perhaps due to the use of claims data. The County Health Rankings did not show statistical significance related to health outcomes or factors in depressed patients. Dual eligible or Medicaid insurance – a substitute for low socioeconomic status – was observed at a higher proportion in the heart failure cohort, but it was not in the hospital medicine group. Future studies may benefit from using physician notes, more specific patient areas such as zip codes, and examining secondary insurance of geriatric heart failure patients.
Laurie Rinehart-Thompson, JD, RHIA, CHP (Advisor)
Jill Clutter, PhD (Committee Member)
Amanda Sabol, Pharm-D, RPh, BCPS (Committee Member)
80 p.
Health Care; Health Care Management; Health Sciences

Recommended Citations

Citations

  • McIntyre, S. M. (2019). Determining the Effect of Depression on Geriatric Heart Failure Readmissions: A Retrospective Cohort Study [Master's thesis, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1555451811558217

    APA Style (7th edition)

  • McIntyre, Sean. Determining the Effect of Depression on Geriatric Heart Failure Readmissions: A Retrospective Cohort Study. 2019. Ohio State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1555451811558217.

    MLA Style (8th edition)

  • McIntyre, Sean. "Determining the Effect of Depression on Geriatric Heart Failure Readmissions: A Retrospective Cohort Study." Master's thesis, Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1555451811558217

    Chicago Manual of Style (17th edition)

osu1555451811558217
313
© 2019, some rights reserved.Creative Commons License Determining the Effect of Depression on Geriatric Heart Failure Readmissions: A Retrospective Cohort Study by Sean Michael McIntyre is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License. Based on a work at etd.ohiolink.edu.
This open access ETD is published by The Ohio State University and OhioLINK.