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Neighborhood disadvantage and 30-day readmission risk following Clostridioides difficile infection hospitalization.


ABSTRACT: BACKGROUND:Clostridioides difficile infection (CDI) is commonly associated with outcomes like recurrence and readmission. The effect of social determinants of health, such as 'neighborhood' socioeconomic disadvantage, on a CDI patient's health outcomes is unclear. Living in a disadvantaged neighborhood could interfere with a CDI patient's ability to follow post-discharge care recommendations and the success probability of these recommendations, thereby increasing risk of readmission. We hypothesized that neighborhood disadvantage was associated with 30-day readmission risk in Medicare patients with CDI. METHODS:In this retrospective cohort study, odds of 30-day readmission for CDI patients are evaluated controlling for patient sociodemographics, comorbidities, and hospital and stay-level variables. The cohort was created from a random 20% national sample of Medicare patients during the first 11?months of 2014. RESULTS:From the cohort of 19,490 patients (39% male; 80% white; 83% 65?years or older), 22% were readmitted within 30?days of an index stay. Unadjusted analyses showed that patients from the most disadvantaged neighborhoods were readmitted at a higher rate than those from less disadvantaged neighborhoods (26% vs. 21% rate: unadjusted OR?=?1.32 [1.20, 1.45]). This relationship held in adjusted analyses, in which residence in the most disadvantaged neighborhoods was associated with 16% increased odds of readmission (adjusted OR?=?1.16 [1.04, 1.28]). CONCLUSIONS:Residence in disadvantaged neighborhoods poses a significantly increased risk of readmission in CDI patients. Further research should focus on in-depth assessments of this population to better understand the mechanisms underlying these risks and if these findings apply to other infectious diseases.

SUBMITTER: Scaria E 

PROVIDER: S-EPMC7565791 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Neighborhood disadvantage and 30-day readmission risk following Clostridioides difficile infection hospitalization.

Scaria Elizabeth E   Powell W Ryan WR   Birstler Jen J   Alagoz Oguzhan O   Shirley Daniel D   Kind Amy J H AJH   Safdar Nasia N  

BMC infectious diseases 20201016 1


<h4>Background</h4>Clostridioides difficile infection (CDI) is commonly associated with outcomes like recurrence and readmission. The effect of social determinants of health, such as 'neighborhood' socioeconomic disadvantage, on a CDI patient's health outcomes is unclear. Living in a disadvantaged neighborhood could interfere with a CDI patient's ability to follow post-discharge care recommendations and the success probability of these recommendations, thereby increasing risk of readmission. We  ...[more]

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