Doctor of Philosophy (PhD) in Health Science
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College of Health Care Sciences – Health Science Department
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Sara Knox. 2017. Pneumonia Readmissions in Older Adults with Dementia. Doctoral dissertation. Nova Southeastern University. Retrieved from NSUWorks, College of Health Care Sciences – Health Science Department. (8)
Abstract Objective: The purpose of this study was to investigate pneumonia readmissions of older adults with dementia. Readmission rates and predictive factors of older adults with and without dementia were compared in this study. Subjects: A nationally representative sample of 389,198 discharge records, representing 370,003 patients, was extracted from the 2013 Nationwide Readmission Database. Methods: Descriptive statistics were utilized to describe the demographics of the sample population. Differences between groups were analyzed using chi-square or t test statistics as appropriate. A generalized linear model was used to examine predictive factors for pneumonia readmissions. Results: Older adults with dementia had a readmission rate of 23.52% and were 2.9 times more likely to experience a pneumonia readmission than older adults without dementia. Significant differences in characteristics were found when comparing (a) older adults with and without dementia, (b) older adults with and without dementia who were readmitted, and (c) older adults with dementia who were and were not readmitted. Factors that significantly interacted with dementia included (a) discharge disposition, (b) number of chronic conditions, (c) risk of mortality, and (d) median household income. Conclusions: Classifying older adults with dementia as a high-risk group for pneumonia readmissions is supported by the findings of this study. More over, dementia diagnoses significantly affect discharge disposition, there are characteristic differences among older adults with dementia, and comorbidities and risk of mortality significantly affect pneumonia readmissions. Development of strategies to reduce pneumonia readmissions that are tailored to individuals with dementia should be considered.
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