Date of Conferral

12-9-2024

Degree

Doctor of Public Health (DrPH)

School

Health Services

Advisor

Tolulope Osoba,

Abstract

Coronary artery bypass graft (CABG) is associated with a high rate of readmissions within 30 days after discharge. Patient variables such as obesity and socioeconomic status (SES) are modifiable, whereas hospital factors such as location indicate the need for a better regional needs assessment. The purpose of this study was to examine the impact of hospital location, SES, and obesity (independent variables) on the 30-day readmission rate post-CABG (dependent variable) among US patients. Secondary data sets available from the Centers for Medicare & Medicaid Services and the Society of Thoracic Surgery websites were analyzed to assess the impact of location, SES, and obesity on the 30-day readmission rate. Descriptive statistics and logistic regression models were applied to examine the association between the dependent and independent variables. The data validity and reliability were determined by conducting a propensity score matching. Although specific geographic correlations emerged, they did not establish the location as a universal predictor. Hospitals serving lower SES populations were associated with higher readmission rates, suggesting that socioeconomic factors play a critical role in patient recovery and readmission. The study confirmed that higher body mass index associated with an increased likelihood of readmission. This finding was not uniform across all categories of obesity, pointing to a complex interplay between obesity and other postoperative recovery factors. The recommendation is that interventions be multifaceted, encompassing medical treatments, broader social support systems, and lifestyle interventions. Implementations of such interventions will lead to adequate pre-operative processes, lower hospital readmission rate, and improved patient outcomes.

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