Table 1.
Baseline Characteristics of the Study Sample by Intervention Group and Age Group
| PN | Ctrl | 60 years old+ | ≤60 years old | |||
|---|---|---|---|---|---|---|
| (N = 585) | (N = 925) | (N = 1009) | (N = 501) | |||
| p-value | p-value | |||||
| Age at discharge, mean (SD) | 66.4 (15.5) | 63.7 (16.7) | 0.001 | 74 (9.3) | 46.1 (10.3) | <0.001 |
| Female, n (%) | 323 (55.2) | 548 (59.2) | 0.123 | 611 (60.6) | 260 (51.9) | 0.001 |
| Language, n (%) | 0.064 | <0.001 | ||||
| English | 363 (62.1) | 583 (63.0) | 563 (55.8) | 383 (76.4) | ||
| Portuguese | 97 (16.6) | 113 (12.2) | 163 (16.2) | 47 (9.4) | ||
| Spanish | 43 (7.4) | 88 (9.5) | 86 (8.5) | 45 (9.0) | ||
| Other | 82 (14.0) | 141 (15.2) | 197 (19.5) | 26 (5.2) | ||
| Race, n (%) | 0.800 | <0.001 | ||||
| White | 337 (57.6) | 532 (57.5) | 585 (58.0) | 284 (56.7) | ||
| Black | 94 (16.1) | 144 (15.6) | 177 (17.5) | 61 (12.2) | ||
| Hispanic | 86 (14.7) | 151 (16.3) | 123 (12.2) | 114 (22.8) | ||
| Other | 68 (11.6) | 98 (10.6) | 124 (12.3) | 42 (8.4) | ||
| Health insurance type, n (%) | 0.623 | <0.001 | ||||
| Medicare | 174 (29.7) | 245 (26.5) | 407 (40.3) | 12 (2.4) | ||
| Medicaid | 165 (28.2) | 276 (29.8) | 199 (19.7) | 242 (48.3) | ||
| Duals Medicare and Medicaid | 135 (23.1) | 208 (22.5) | 237 (23.5) | 106 (21.2) | ||
| Health Safety Net* | 70 (12.0) | 123 (13.3) | 118 (11.7) | 75 (15.0) | ||
| Commercial/other | 41 (7.0) | 73 (7.9) | 48 (4.8) | 66 (13.2) | ||
| Weighted Charlson score, mean (SD) | 1.3 (1.6) | 1.1 (1.5) | 0.004 | 1.3 (1.5) | 0.9 (1.5) | <0.001 |
| Chronic behavioral health issues | ||||||
| Substance abuse or psychiatric diagnosis, n (%) | 272 (46.5) | 494 (53.4) | 0.009 | 421 (41.7) | 345 (68.9) | <0.001 |
| Psychiatric diagnosis†, n (%) | 222 (37.9) | 397 (42.9) | 0.056 | 348 (34.5) | 271 (54.1) | <0.001 |
| Substance abuse‡, n (%) | 126 (21.5) | 272 (29.4) | <0.001 | 159 (15.8) | 239 (47.7) | <0.001 |
| Dementia | 65(11.1) | 109(11.8) | 0.690 | 107(10.6) | 67(13.4) | 0.113 |
| Qualifying risks of readmission | ||||||
| 60 years old+, n (%) | 425 (72.6) | 584 (63.1) | <0.001 | |||
| Index admission, LOS ≥3 days, n (%) | 261 (44.6) | 467 (50.5) | 0.026 | 395 (39.1) | 333 (66.5) | <0.001 |
| Admission at CHA in past 6 months, n (%) | 167 (28.5) | 257 (27.8) | 0.748 | 149 (14.8) | 275 (54.9) | <0.001 |
| COPD§, n (%) | 50 (8.5) | 63 (6.8) | 0.212 | 71 (7.0) | 42 (8.4) | 0.349 |
| Heart failure§, n (%) | 40 (6.8) | 38 (4.1) | 0.020 | 65 (6.4) | 13 (2.6) | 0.001 |
| Outpatient visit(s) in previous month, n (%) | 360 (61.5) | 570 (61.6) | 0.974 | 611 (60.6) | 319 (63.7) | 0.241 |
| Length of stay, mean (SD) | 3 (2.4) | 3.5 (3.8) | 0.003 | 2.8 (3.0) | 4.3 (3.8) | <0.001 |
| Discharge against medical advice, n(%) | 12(2.1) | 16(1.7) | 0.652 | 9(0.9) | 19(3.8) | <0.001 |
*Health Safety Net is a Massachusetts state program for uninsured patients
†Based on ICD-9 discharge codes: 290–302.9 and 306–319
‡Based on ICD-9 discharge codes: 303–305.93
§Based on primary Emergency Department admission diagnosis