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Post-Surgical Readmissions Higher Among Homeless Veterans

TUESDAY, May 22, 2018 -- Readmissions are higher in homeless veterans discharged to the community after surgery, compared to housed veterans, according to a study published in the June issue of Medical Care.

Ashley Titan, M.D., from the VA Palo Alto Health Care System in California, and colleagues compared surgical readmissions (general: 39 percent; vascular: 18 percent; orthopedic: 43 percent) among homeless versus housed Veteran patients (2008 to 2014).

The researchers found that of the 232,373 surgeries, 5,068 were performed on homeless patients. Compared to housed patients, homeless individuals were younger (56 versus 64 years), more likely to have psychiatric comorbidities (51.3 versus 19.4 percent), and less likely to have other medical comorbidities, including hypertension (57.1 versus 70.8 percent). Readmission was higher among homeless patients (odds ratio, 1.43). Within the homeless cohort, discharge destination other than community (odds ratio, 0.57), recent alcohol abuse (odds ratio, 1.45), and elevated American Society of Anesthesiologists classification (odds ratio, 1.86) were significant risk factors associated with readmissions.

"Judicious use of postoperative nursing or residential rehabilitation programs may be effective in reducing readmission and improving care transitions among these vulnerable veterans," the authors write.

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Posted: May 2018