Introduction: Self-rated health status is often assessed yet whether these data are predictive of future risk for rehospitalization following cardiovascular admissions not been evaluated.
Methods: We evaluated 520 cardiac patients who were admitted to Duke Heart Center from January 1, 2015 through January 10, 2017. Self-rated health was measure by a 5-point Likert scale. The primary outcome measure was all-cause readmission to the same hospital within 30 days of discharge. Logistic regression models were used to examine the association between self-rated health status and 30-day readmission while adjusting for patient demographics, socioeconomic status, psychosocial factors, health behaviors, and health status.
Results: The median age of study participants was 65 years, 61.2% were men, 64.6% were non-Hispanic white, and the median index hospital stay was 5.1 days. Of 520 participants, the prevalence of heart failure, acute myocardial infarction, and atrial fibrillation were 34.0%, 11.4%, and 30.3%, respectively. Overall, 20.2% were readmitted within 30 days; nearly 20% of patients reported poor self-rated health. Those who were younger, had depressive symptoms, had higher levels of stress, and had any physical disabilities were significantly more likely to report poor self-rated health. Those with poor self-rated health rating were more likely to be readmitted within 30 days than those not (31.0% vs. 16.9%, p=.001). After adjustment for multiple confounding factors, poor self-reported health remained a significant risk factor for readmission (OR=2.29; 95% CI [1.51 to 3.49])
Conclusion: Patient-reported health status is strongly associated with 30-day readmission in cardiac patients and may be useful for identifying patients who many benefit from more intensive discharge interventions and close follow up.