Abstract
Patients who are discharged to home health care (HHC) after a hospitalization for sepsis may experience high rates of readmission, functional decline, and mortality. The presence of one or more geriatric syndromes (GS) may exacerbate these negative outcomes. This purpose of this retrospective study was to identify the prevalence of GSs and describe their cumulative effects associated with healthcare utilization (rehospitalization, skilled nursing facility or sub-acute rehabilitation placement) and death in sepsis survivors recently discharged to HHC. Utilizing the Medicare administrative, Outcome and Assessment Information Set, and claims data from the Chronic Condition Warehouse for beneficiaries receiving HHC, six GSs (frailty, incontinence, falls, depression, pressure ulcers and functional decline) were identified. Overall, 91.6% of patients had one or more GSs. At 30 days post hospitalization, sepsis survivors with incontinence or pressure ulcers had a higher rate of rehospitalization and death than patients without these GSs. At seven days after discharge the rate of death was more than double for patients with a pressure ulcer (24.8%) when compared to those without (8.46%). However, risk of 30-day rehospitalization did not increase with increased number of GSs. Improvements in the assessment and identification of GSs in HHC are needed. Prompt and proper identification of GS can lead to early identification of at-risk older adults and timely, focused interventions to improve health outcomes.