Date of Award

Fall 12-2018

Degree Type

Dissertation

Degree Name

PhD Health Sciences

Department

Health and Medical Sciences

Advisor

Ning (Jackie) Zhang, Ph.D.

Committee Member

Genevieve Pinto Zipp, Ed.D.

Committee Member

Glenn Beamer, Ph.D.

Keywords

Hospital Readmissions, Thirty-Day Readmissions, Drug/Medication Poisoning, United States Hospital Readmissions, Drug/Medication Readmissions

Abstract

A common and costly occurrence in the United States is thirty-day hospital readmissions. Awareness of 30-day hospital readmissions is currently a national priority. To reduce avoidable readmissions, the Patient Protection and Affordable Care Act of 2010 established a “Hospital Readmission Reduction Program” implemented to provide possible solutions for preventable thirty-day readmissions. Part of this policy states that hospitals with higher than expected adjusted re-hospitalization rates have lower reimbursement rates. One specific area known to be a cause of thirty-day hospital readmissions is drug and medication poisoning. An observational study of data from the Nationwide Readmissions Database is being used to help identify contributing factors and provide suggestions for preventable thirty-day readmissions relative to drug and medication poisoning. Factors that include: gender; demographics; cost index; socio-economic, and hospital factors are identified to aid in the understanding of thirty-day hospital readmission of drug and medication poisoning. Finally, suggestions based on quantitative analyses contribute to the understanding of risk factors of thirty-day readmissions in drug and medication poisoning occurrences. Outcomes include statistical significance in gender and significance in the cost index of the individual patient; such as the ability to pay or not to pay for services rendered. Certain socio-economic factors whereas contributed, however, overall socioeconomic status was not significant along with hospital specific factors being insignificant. The study resulted in the identification of factors to aid in drug/medication episodic occurrences in a patient population experiencing thirty-day readmissions. Prevention strategy from both a clinical and practical application may be used to initiate cost saving applications. Future studies suggest expanding on drug and medication poisoning in certain sub-specific populations, further identifying illegal vs. legal drug/medication differentiation, and conducting international comparisons based on current findings.

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