Abstract
Pneumonia readmissions have significant quality of care and policy implications for patients and health care providers. Research suggests that initiatives to decrease readmissions should target high-risk subgroups. Older adults with dementia are known to be at an increased risk of contracting pneumonia and have higher hospitalization rates due to pneumonia, suggesting that older adults with dementia may be at high-risk of pneumonia readmissions. There is a lack of research addressing the relationship between dementia and pneumonia readmissions. The purpose of this retrospective study was to investigate pneumonia readmission rates and predictive factors of older adults with and without dementia. A nationally representative sample of 389,198 discharge records was extracted from the 2013 Nationwide Readmission Database. Significant differences were found (p<.001) when comparing patient characteristics of older adults with and without dementia who were readmitted within 30 days of discharge. Older adults with dementia had a readmission rate of 23.5% and were 2.9 times more likely to be readmitted (OR; 95% CI, 1.93,4.40) than older adults without dementia. Predictive factors were calculated using a generalized linear model with dementia included as an interactive effect. Dementia significantly modified (p<.05) the relationship between pneumonia readmissions and four factors; (a) discharge disposition, (b) chronic conditions, (c) risk of mortality, and (d) median household income. Classifying older adults with dementia as a high-risk sub-group for pneumonia readmissions is supported by the findings of this study. Development of strategies to reduce pneumonia readmissions that are tailored to individuals with dementia should be considered.