1901 Determinants of hospital readmissions in older people with dementia: A scoping review
Bibliographic record
Abstract
Abstract Introduction In the UK, fifty-three percent of hospitalised older people with dementia have multimorbidity, and are at an increased risk of hospital readmission within 30 days from discharge. Between 20-40% of these readmissions are preventable [1]. Current research focused on the biological causes of readmissions. However, older people with dementia have additional psychosocial factors increasing their risk of readmission. The aim of this scoping review was to identify psychosocial determinants within the context of known biological factors. Methods Electronic databases MEDLINE, EMBASE, CINAHL and PsychInfo were searched from inception until July 2022. Quantitative and qualitative studies in English including adults aged 65 years and over with dementia, their care workers and informal carers were considered if they investigated readmission. An inductive approach was adopted to map determinants of hospital readmission. Identified themes were described as narrative categories. Results Seventeen studies including 7,194,878 participants met our inclusion criteria from a total of 4736 articles. Sixteen quantitative studies included observational cohort and randomised controlled trial designs. One American study was qualitative. Ten studies were based in the USA, and one study each from Taiwan, Australia, Canada, Sweden, Japan, Denmark, and The Netherlands. Large hospital and insurance records provided data in over 2 million patients in one American study. Identified psychosocial determinants included inadequate hospital discharge planning, limited interdisciplinary collaboration, and socioeconomic inequalities among ethnic minorities. Biological determinants included reduced mobility and accumulation of comorbidities. Use of antipsychotic medications might explain the interplay between biological and psychosocial determinants. Conclusion Poorly defined roles and responsibilities of health and social care professionals and poor communication during care transitions increase the risk of readmission in older people with dementia. Reference 1. Godard-Sebillotte C, Strumpf E, Sourial N, et al. L. Primary care continuity and potentially avoidable hospitalization in persons with dementia. J Am Geriatr Soc. 2021;69(5):1208-20.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".