Behavioral,Cognitive,and Functional Risk Factors for Repeat Hospital Episodes Among Medicare–Medicaid Dually Eligible Adults Receiving Long-Term Services and Supports

Abstract

Repeat hospitalizations adversely impact the well-being of adults dually eligible for Medicare and Medicaid in the United States. This study aimed to identify behavioral, cognitive, and functional characteristics associated with the risk of a repeat hospital episode (HE) among the statewide population of dually eligible adults in Maryland receiving long-term services and supports prior to an HE between July 2018 and May 2020. The odds of experiencing a repeat HE within 30 days after an initial HE were positively associated with reporting difficulty with hearing (adjusted odds ratio, AOR: 1.10 [95% confidence interval: 1.02–1.19]), being easily distractible (AOR: 1.09 [1.00–1.18]), being self-injurious (AOR: 1.33 [1.09–1.63]), and exhibiting verbal abuse (AOR: 1.15 [1.02–1.30]). Conversely, displaying inappropriate public behavior (AOR: 0.62 [0.42–0.92]) and being dependent for eating (AOR: 0.91 [0.83–0.99]) or bathing (AOR: 0.79 [0.67–0.92]) were associated with reduced odds of a repeat HE. We also observed differences in the magnitude and direction of these associations among adults 65 years of age or older relative to younger counterparts.

Keywords

dually eligible long-term services and supports readmission Minimum Data Set interRAI Home Care

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