Behavioral factors and hospital admissions/readmissions in patients with CHF.

BACKGROUND

Wasted health care resources have become a central concern in American health care. Heart failure has one of the highest readmission rates amongst all conditions studied in Medicare/Medicaid populations.

OBJECTIVE

The present study was an attempt to cross-sectionally identify correlates of number of past-year admissions and 30-day readmissions in patients with congestive heart failure.

METHODS

Eighty-four patients with congestive heart failure were recruited during hospitalization and underwent a semistructured interview for basic clinical/demographic information and completed several questionnaires measuring depression, anxiety, and spirituality.

RESULTS

Depression, history of substance abuse, and history of coronary artery disease displayed borderline results as correlates of past-year admissions. Immediate memory and psychiatric history (positive Patient Health Questionnaire 9, acknowledged history of treatment, and use of an antidepressant per chart) were associated with 30-day readmission rates. Indices of congestive heart failure severity (ejection fraction and last recorded B-type natriuretic peptide level) were not.

CONCLUSIONS

Present results suggest that both a psychiatric history and cognitive impairment are possible determinants of early readmission.