Impatto di fattori socioeconomici sulle riammissioni ospedaliere, in pazienti con età superiore ai 65 anni, ricoverati con una diagnosi di insufficienza cardiaca o infarto miocardico acuto: una revisione sistematica della letteratura

Translated title of the contribution: [Autom. eng. transl.] Impact of socioeconomic factors on hospital readmissions, in patients over the age of 65, hospitalized with a diagnosis of heart failure or acute myocardial infarction: a systematic literature review

Gualtiero Ricciardi, Gianfranco Damiani, Lanfranco Iodice, Giulia Silvestrini, Eleonora Salvatori, Ivana Ivanova, Luka Bojovic

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

[Autom. eng. transl.] INTRODUCTION: Cardiovascular diseases represent one of the main causes of death and disability in the world. Among these, heart failure (IC) and acute myocardial infarction (AMI) are among the major causes of hospital readmission. In 2011, it was estimated that 6.5% of patients in the UK and 14.2% of patients over 75 in France were readmitted to the hospital within 30 days after discharge. In the United States, between 2005 and 2008, the hospital readmission rate was 24.4%, in patients with IC and 19.9%, in patients with AMI. Several socioeconomic factors impact on the risk of readmission. In this regard, the objective of this systematic review was to analyze the impact of certain socio-economic factors on the risk of readmission within 30 and 90 days of discharge, in an elderly population, over 65 years, suffering from IC or IMA. MATERIALS AND METHODS: The systematic review was conducted on the basis of the guidelines of the "PRISMA Statement", by querying the Medline database and by manually searching for articles. The review included studies evaluating the association between hospital readmission, at 30 or 90 days after discharge, and at least one socioeconomic factor, in patients with IC or AM, over 65 years of age. Furthermore, an evaluation of the quality of the included studies was carried out, carried out independently by two reviewers, through the "STROBE Statement". The level of agreement between the reviewers was calculated using the Cohen K. Data analysis was organized based on the type of outcome considered and on the basis of the socio-economic variables investigated. When exposure to a condition of socio-economic disadvantage increased the risk of readmission, it was considered a positive effect of the socio-economic variable, while a negative effect of the variable was considered in the event that the socio-economic disadvantage was associated with a reduction in the readmission risk and finally in the event that there was no relationship between the socio-economic variable and the risk of readmission, a null effect of the variable was considered. RESULTS: From a total of 2016 studies obtained, 7 were included in the review. All studies analyzed patients with IC and 4 of these also included patients with AMI. At 30 days after discharge, for both diseases, a positive effect was found in all the studies that analyzed the "race / ethnicity" variable: among Hispanics and African Americans, a higher risk of readmission was highlighted. Furthermore, with regard to a single study identified, for both pathologies, a positive effect of the "income" variable was detected, as patients with lower income levels had a higher risk of readmission. At 90 days from discharge, only the "civil status" variable, among the other suspects, showed a positive effect, with a greater risk of readmission found among patients without a partner. CONCLUSIONS: The variables race / ethnicity and marital status have shown a positive effect, while for the income we have still insufficient evidences, in relation to the risk of readmission for elderly patients with IC or IMA. Mechanisms of protection of the transition, even within unified long-assistance programs, which involve actors and organizations offering different services, whose objective is to guarantee continuity of care, are a priority for health systems, not just to improve the level of welfare integration, but also to reduce the disparities that impact on risk
Translated title of the contribution[Autom. eng. transl.] Impact of socioeconomic factors on hospital readmissions, in patients over the age of 65, hospitalized with a diagnosis of heart failure or acute myocardial infarction: a systematic literature review
Original languageItalian
Title of host publicationATTI del 47° Congresso Nazionale SItI - Poster
Pages703-704
Number of pages2
Publication statusPublished - 2014
Event47° Congresso Nazionale SItI - Riccione
Duration: 1 Oct 20144 Oct 2014

Conference

Conference47° Congresso Nazionale SItI
CityRiccione
Period1/10/144/10/14

Keywords

  • fattori socioeconomici
  • riammissioni ospedaliere

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