Evidence map›Paper›PMID 30853424›Full record

ArticleJournal of the American Medical Directors Association2019

Hospital Readmissions Among Post-acute Nursing Home Residents: Does Obesity Matter?

Shubing Cai, Sijiu Wang, Dana B Mukamel, Thomas Caprio, Helena Temkin-Greener

Open access · greenAbstract read
In one paragraph

Article in Journal of the American Medical Directors Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Shubing CaiDepartment of Public Health Sciences, University of Rochester School of Medicine, Rochester, NY. Electronic address: Shubing_cai@urmc.rochester.edu.
Sijiu WangDepartment of Public Health Sciences, University of Rochester School of Medicine, Rochester, NY.
Dana B MukameliTEQC Research Program, Medicine-Division of General Internal Medicine, University of California, Irvine, CA.
Thomas CaprioDepartment of Medicine, University of Rochester School of Medicine, Rochester, NY.
Helena Temkin-GreenerDepartment of Public Health Sciences, University of Rochester School of Medicine, Rochester, NY.
University of Rochester · USUniversity of California, Irvine · USUniversity of Rochester Medical Center · US

Funding

Home and community based services among persons with ADRDR01AG052451 · NIA · UNIVERSITY OF ROCHESTER · PI CAI, SHUBING · 2016 to 2018
$1.4M
NIA NIH HHS R01 AG052451
6 · The paper itself

Abstract

objectivesTo explore profiles of obese residents who receive post-acute care in nursing homes (NHs) and to assess the relationship between obesity and hospital readmissions and how it is modified by individual comorbidities, age, and type of index hospitalizations.

designRetrospective cohort study. SETTING AND

participantsMedicare fee-for-service beneficiaries who were newly admitted to free-standing US NHs after an acute inpatient episode between 2011 and 2014 (N = 2,323,019). MEASURES: The Minimum Data Set 3.0 were linked with Medicare data. The outcome variable was 30-day hospital readmission from an NH. Residents were categorized into 3 groups based on their body mass index (BMI): nonobese, mildly obese, moderate-to-severely obese. We tested the relationship between obesity and 30-day readmissions by fixed-effects logit models and stratified analyses by the type of index hospitalization and residents' age.

resultsForty percent of the identified residents were admitted after a surgical episode, and the rest were admitted after a medical episode. The overall relationship between obesity and readmissions suggested that obesity was associated with higher risks of readmission among the oldest old (≥85 years) residents but with lower risks of readmission among the youngest group (65-74 years). After accounting for individual co-covariates, the association between obesity and readmissions among the oldest old residents became weaker; the adjusted odds ratio was 1.061 (P = .049) and 1.004 (P = .829) for moderate-to-severely obese patients with surgical and medical index hospitalizations, respectively. The protective effect of obesity among younger residents reduced after adjusting for covariates. CONCLUSIONS/RELEVANCE: The relationship between obesity and hospital readmission among post-acute residents could be affected by comorbidities, age, and the type of index hospitalization. Further studies are also warranted to understand how to effectively measure NH quality outcomes, including hospital readmissions, so that policies targeting at quality improvement can successfully achieve their goals without unintended consequences.

Indexed as

Nursing HomesObesityPatient ReadmissionAgedAged, 80 and overBody Mass IndexDatabases, FactualFemaleHumansMaleMedicareRetrospective StudiesUnited Statesnursing homeobesitypost-acuteReadmission

Identifiers

PMID30853424
PMCPMC7273841
OpenAlexW2922462172

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.