Date of Conferral

2023

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Management

Advisor

James Rohrer

Abstract

AbstractHospital readmissions have continuously been a concern to healthcare providers and policymakers because of their negative impacts on the economy and the well-being of patients. A gap in knowledge exists in the understanding of the factors that have led to increased readmissions due to chronic cardiovascular diseases (Heart Failure) and respiratory diseases (chronic obstructive pulmonary disease [COPD] and Asthma). The aim of this study was to examine the relationship between poverty rate and hospital readmission rates for patients with COPD, Heart Failure, and Asthma in the United States using secondary data from the Healthcare Cost and Utilization Project’s (HCUP’s) Nationwide Readmission Database (NRD). The study sample was composed of 246,657, 54,640 and 77,189 readmission cases for COPD, Heart Failure and Asthma respectively. This study was aligned to Andersen’s behavioral model of health services, which asserted that the use of health care services was supply induced and therefore strongly dependent on the structures of health systems. Furthermore, an individual’s social characteristics also influence their utilization of health care services. Multivariable regression and correlation analyses were performed on the data. Readmission for COPD and Heart Failure were associated with poverty rate with the hospital readmission rate higher for patients below the poverty rate. Health practitioners and administrators should consider creating measures to reduce growing inequalities in health care delivery to ensure that the financial status of patients does not hinder their access to medical care. By addressing health care inequalities due to patients' economic status, stakeholders will be in a position to improve health care utilization and outcomes, thus effecting positive social change.

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