Determinants of health after hospital discharge: rationale and design of the Vanderbilt Inpatient Cohort Study (VICS)

BMC Health Services Research

Sunil Kripalani⁸  Frank E Harrell⁷  Chandra Y Osborn⁸  Jonathan S Schildcrout⁷  Susan P Bell¹  John F Schnelle²  Katharine M Donato³  Liana D Castel⁸  Russell L Rothman⁸  Corinne M Davis⁵  Kathryn M Goggins⁵  Eduard E Vasilevskis⁸  Courtney Cawthon⁵  Kenneth A Wallston⁶  Amanda Salanitro⁸  Abby G Meyers⁴ 

[1]Division of Cardiovascular Medicine, Vanderbilt University, Nashville, TN, USA

[2]Center for Quality Aging, Vanderbilt University, Nashville, TN, USA

[3]Department of Sociology, Vanderbilt University, Nashville, TN, USA

[4]Vanderbilt University School of Medicine, Nashville, TN, USA

[5]Center for Health Services Research, Vanderbilt University, Nashville, TN, USA

[6]School of Nursing, Vanderbilt University, Nashville, TN, USA

[7]Department of Biostatistics, Vanderbilt University, Nashville, TN, USA

[8]Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University, 1215 21st Ave S, Suite 6000 Medical Center East, Nashville 37232, TN, USA

关键词: Social determinants;    Health literacy;    Transitions of care;    Patient readmission;    Patient discharge;    Hospitalization;   

Others  :  1134349
DOI  :  10.1186/1472-6963-14-10

 received in 2013-09-27, accepted in 2014-01-03,  发布年份 2014

【 摘 要 】

Background

The period following hospital discharge is a vulnerable time for patients when errors and poorly coordinated care are common. Suboptimal care transitions for patients admitted with cardiovascular conditions can contribute to readmission and other adverse health outcomes. Little research has examined the role of health literacy and other social determinants of health in predicting post-discharge outcomes.

Methods

The Vanderbilt Inpatient Cohort Study (VICS), funded by the National Institutes of Health, is a prospective longitudinal study of 3,000 patients hospitalized with acute coronary syndromes or acute decompensated heart failure. Enrollment began in October 2011 and is planned through October 2015. During hospitalization, a set of validated demographic, cognitive, psychological, social, behavioral, and functional measures are administered, and health status and comorbidities are assessed. Patients are interviewed by phone during the first week after discharge to assess the quality of hospital discharge, communication, and initial medication management. At approximately 30 and 90 days post-discharge, interviewers collect additional data on medication adherence, social support, functional status, quality of life, and health care utilization. Mortality will be determined with up to 3.5 years follow-up. Statistical models will examine hypothesized relationships of health literacy and other social determinants on medication management, functional status, quality of life, utilization, and mortality. In this paper, we describe recruitment, eligibility, follow-up, data collection, and analysis plans for VICS, as well as characteristics of the accruing patient cohort.

Discussion

This research will enhance understanding of how health literacy and other patient factors affect the quality of care transitions and outcomes after hospitalization. Findings will help inform the design of interventions to improve care transitions and post-discharge outcomes.

【 授权许可】

   
2014 Meyers et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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