TY - JOUR
T1 - Do-not-resuscitate orders and readmission among elderly patients with heart failure in Pennsylvania
T2 - An observational study, 2011 - 2014
AU - Callahan, Katherine
AU - Kitko, Lisa
AU - Van Scoy, Lauren J.
AU - Hollenbeak, Christopher S.
N1 - Funding Information:
Disclaimer: The Pennsylvania Health Care Cost Containment Council (PHC4) is an independent state agency responsible for addressing the problem of escalating health costs, ensuring the quality of health care, and increasing access to health care for all citizens regardless of ability to pay. PHC4 has provided data to Penn State College of Medicine in an effort to further PHC4?s mission of educating the public and containing health care costs in Pennsylvania. PHC4, its agents, and staff, have made no representation, guarantee or warranty, expressed or implied, that the data - financial, patient, payor and physician specific information - provided, are error-free, or that the use of the data will avoid differences of opinion or interpretation. This analysis was not prepared by PHC4. This analysis was done by the authors. PHC4, its agents and staff, bear no responsibility or liability for the results of the analysis, which are solely the opinion of the authors.
Publisher Copyright:
© 2020 Elsevier Inc.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Background: Readmissions for patients with heart failure (HF) continues to be a target of value-based purchasing initiatives. Do-not-resuscitate (DNR) orders—one part of advance care planning (ACP)—have been shown to be related to other patient outcomes but has not been explored as a risk factor for HF readmission. Objectives: Examine the association between DNR and 30-day readmissions among elderly patients with HF admitted to hospitals in Pennsylvania. Methods: Data included hospital discharges from 2011 to 2014 of patients 65+ years with a primary diagnosis of HF. Logistic regression was used to model the relationship between DNR and 30-day readmission. Results: Among 107,806 patients, 20.9% were readmitted within 30 days. After controlling for covariates, patients with HF who had a DNR were less likely to be readmitted to the hospital (OR=0.85, 95% CI: 0.80–0.91, p<0.001). Conclusions: Documentation of a DNR may inform efforts to reduce readmissions among elderly patients with HF.
AB - Background: Readmissions for patients with heart failure (HF) continues to be a target of value-based purchasing initiatives. Do-not-resuscitate (DNR) orders—one part of advance care planning (ACP)—have been shown to be related to other patient outcomes but has not been explored as a risk factor for HF readmission. Objectives: Examine the association between DNR and 30-day readmissions among elderly patients with HF admitted to hospitals in Pennsylvania. Methods: Data included hospital discharges from 2011 to 2014 of patients 65+ years with a primary diagnosis of HF. Logistic regression was used to model the relationship between DNR and 30-day readmission. Results: Among 107,806 patients, 20.9% were readmitted within 30 days. After controlling for covariates, patients with HF who had a DNR were less likely to be readmitted to the hospital (OR=0.85, 95% CI: 0.80–0.91, p<0.001). Conclusions: Documentation of a DNR may inform efforts to reduce readmissions among elderly patients with HF.
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U2 - 10.1016/j.hrtlng.2020.09.012
DO - 10.1016/j.hrtlng.2020.09.012
M3 - Article
C2 - 33010520
AN - SCOPUS:85091785166
VL - 49
SP - 812
EP - 816
JO - Heart and Lung: Journal of Acute and Critical Care
JF - Heart and Lung: Journal of Acute and Critical Care
SN - 0147-9563
IS - 6
ER -