Date of Award

Fall 10-30-2019

Degree Type

Dissertation

Degree Name

PhD Health Sciences

Department

Health and Medical Sciences

Advisor

Ning Jackie Zhang, PhD

Committee Member

Terrance Cahill, EdD

Committee Member

Michelle D'Abundo, PhD

Keywords

Social Determinants of Heath, 30-Day Readmission, Binary Logistic Regression

Abstract

ABSTRACT

Relationships between social determinants of health and patient readmissions to an acute-care hospital within 30 days of discharge

Background: The Hospital Readmission Reduction Program (HRRP) is a part of the Affordable Care Act (ACA), which addresses the cost and quality of health care. The HRRP and policy penalizes hospitals for excessive readmission rates. The overall purpose of the program is to improve the quality of care, reduce costs and improve operational efficiency in hospitals. (Zhang, 2014).

Purpose: The purpose of this study was to identify and examine what social determinants of health, at an individual level and community level, were associated with the likelihood of being readmitted into the hospital, within 30 days of discharge, for patients at a hospital in Hudson County, NJ.

Methods: A non-experimental design, with secondary data and observational analysis was used to conduct this study with de-identified patient level details (Cohen, 2000).

Description of the Data: There were over 77,000 patients in the database created from the Electronic Medical Records (EMR) of all patients discharged between 2009-2016, from one acute care hospital.

Results:The main statistical test used for the analysis was Two-Level Binary Logistic Regression. Preceding Chi-Square analyses were performed on the categorical social factors as well. Nine of the eleven social factors produced significant p values

Conclusions: The results of this study show a patient’s 30-day readmission is influenced by the individual factors and community factors.

Key Words: Social Determinants of Health, 30-Day Readmission, Two-Level Binary Logistic Regression Analysis

Available for download on Monday, December 23, 2019

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