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Community factors and hospital wide readmission rates: Does context matter?

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  • Erica S Spatz
  • Susannah M Bernheim
  • Leora I Horwitz
  • Jeph Herrin

Abstract

Background: The environment in which a patient lives influences their health outcomes. However, the degree to which community factors are associated with readmissions is uncertain. Objective: To estimate the influence of community factors on the Centers for Medicare & Medicaid Services risk-standardized hospital-wide readmission measure (HWR)–a quality performance measure in the U.S. Research design: We assessed 71 community variables in 6 domains related to health outcomes: clinical care; health behaviors; social and economic factors; the physical environment; demographics; and social capital. Subjects: Medicare fee-for-service patients eligible for the HWR measure between July 2014-June 2015 (n = 6,790,723). Patients were linked to community variables using their 5-digit zip code of residence. Methods: We used a random forest algorithm to rank variables for their importance in predicting HWR scores. Variables were entered into 6 domain-specific multivariable regression models in order of decreasing importance. Variables with P-values

Suggested Citation

  • Erica S Spatz & Susannah M Bernheim & Leora I Horwitz & Jeph Herrin, 2020. "Community factors and hospital wide readmission rates: Does context matter?," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-14, October.
    • Handle: RePEc:plo:pone00:0240222
    DOI: 10.1371/journal.pone.0240222
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    1. Shervin Assari, 2018. "Racial Variation in the Association between Educational Attainment and Self-Rated Health," Societies, MDPI, vol. 8(2), pages 1-11, April.
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