Background: Medicare spends $17 billion yearly on 30-day readmissions. Hispanic adults have a higher prevalence of diabetes (12.6%) compared to non-Hispanic whites (9.4%). Those with a diagnosis of diabetes have the 17% higher rate (14-23%) for 30-day readmission. Little research has been conducted on Hispanics with diabetes relative to 30-day readmissions. Aims: Among Hispanics with type 2 diabetes: 1) measure the incidence of 30-day readmission by sociodemographic, behavioral and clinical factors;2) identify independent factors associated with 30-day readmission among Hispanic adults with type 2 diabetes accounting for potential covariates; 3) compare the ability of the Hispanic Diabetic Study Model plus ED, to the LACE model. Methods: The overall 30-day readmission rate for the three years of 14.7% (N=5985) and for those in the study cohort of 9.5% (N=3865). The Hispanic-Diabetic model plus ED had ACU of 0.67 with a high specificity of 99.5% and low sensitivity of 5%. However, the PPV (positive predictive value) was 57.4%, much better than 9.5%. Findings: The readmission rate in the cohort declined from 11.8% to 9.5% over time indicate studied hospital has purposefully worked to decrease 30-day readmissions and have been successful among Hispanics with diabetes. Employment status: only 15% were employed, disabled (20%) had an adjusted odd of 2.43, retired (49%, adj 1.68) increased odds of readmission. The number of ED visits prior to admission was the strongest predictor ranging from an adjusted odd of 6.04 for 1 visit to 14.56 for 3 visits. The length of stay OR=1.75 for 4-6 days or an increase of 5% odds for every day in the hospital and smoking marginally increased odds of readmission. Receiving a consult for a home health aide at discharge was an important factor. Surprisingly, the diabetes complications code decreased the odds of 30-day readmission even though HgA1C above 9% did slightly increase odds. The majority were Spanish-speaking (69%), and 70% of all participants were seen by a diabetes nurse practitioner. Implications: Identified key factors of 30-day readmission among Hispanics with diabetes may lead to future targeted interventions effective in reducing readmissions in this population.
","abstract_html":"<p>Background: Medicare spends $17 billion yearly on 30-day readmissions. Hispanic adults have a higher prevalence of diabetes (12.6%) compared to non-Hispanic whites (9.4%). Those with a diagnosis of diabetes have the 17% higher rate (14-23%) for 30-day readmission. Little research has been conducted on Hispanics with diabetes relative to 30-day readmissions. Aims: Among Hispanics with type 2 diabetes: 1) measure the incidence of 30-day readmission by sociodemographic, behavioral and clinical factors;2) identify independent factors associated with 30-day readmission among Hispanic adults with type 2 diabetes accounting for potential covariates; 3) compare the ability of the Hispanic Diabetic Study Model plus ED, to the LACE model. Methods: The overall 30-day readmission rate for the three years of 14.7% (N=5985) and for those in the study cohort of 9.5% (N=3865). The Hispanic-Diabetic model plus ED had ACU of 0.67 with a high specificity of 99.5% and low sensitivity of 5%. However, the PPV (positive predictive value) was 57.4%, much better than 9.5%. Findings: The readmission rate in the cohort declined from 11.8% to 9.5% over time indicate studied hospital has purposefully worked to decrease 30-day readmissions and have been successful among Hispanics with diabetes. Employment status: only 15% were employed, disabled (20%) had an adjusted odd of 2.43, retired (49%, adj 1.68) increased odds of readmission. The number of ED visits prior to admission was the strongest predictor ranging from an adjusted odd of 6.04 for 1 visit to 14.56 for 3 visits. The length of stay OR=1.75 for 4-6 days or an increase of 5% odds for every day in the hospital and smoking marginally increased odds of readmission. Receiving a consult for a home health aide at discharge was an important factor. Surprisingly, the diabetes complications code decreased the odds of 30-day readmission even though HgA1C above 9% did slightly increase odds. The majority were Spanish-speaking (69%), and 70% of all participants were seen by a diabetes nurse practitioner. Implications: Identified key factors of 30-day readmission among Hispanics with diabetes may lead to future targeted interventions effective in reducing readmissions in this population.</p>","abstract_has_math":false,"creators":["Mohebbi, Athena"],"institution":null,"degree_name":"PhD Nursing","degree_level":"Dissertation: Open Access","degree_discipline":"Nursing","degree_department":null,"school":null,"contributors":[],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2019,"date_issued":"2019-10-21T07:00:00Z","date_published":"2019-10-21T07:00:00Z","updated_at":"2026-07-24T05:40:49Z","subjects":["Diabetes Nurse Practitioner","Family Practice Nursing","Other Nursing"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://digital.sandiego.edu/dissertations/162","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:creator","label":"Author","values":["Mohebbi, Athena"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.available","label":"Dc Date Available","values":["2021-11-17T08:00:00Z"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Nursing"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Dissertation: Open Access"]},{"key":"thesis:degree_name","label":"Degree Name","values":["PhD Nursing"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Diabetes Nurse Practitioner","Family Practice Nursing","Other Nursing"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://digital.sandiego.edu/dissertations/162"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Background: Medicare spends $17 billion yearly on 30-day readmissions. Hispanic adults have a higher prevalence of diabetes (12.6%) compared to non-Hispanic whites (9.4%). Those with a diagnosis of diabetes have the 17% higher rate (14-23%) for 30-day readmission. Little research has been conducted on Hispanics with diabetes relative to 30-day readmissions. Aims: Among Hispanics with type 2 diabetes: 1) measure the incidence of 30-day readmission by sociodemographic, behavioral and clinical factors;2) identify independent factors associated with 30-day readmission among Hispanic adults with type 2 diabetes accounting for potential covariates; 3) compare the ability of the Hispanic Diabetic Study Model plus ED, to the LACE model. Methods: The overall 30-day readmission rate for the three years of 14.7% (N=5985) and for those in the study cohort of 9.5% (N=3865). The Hispanic-Diabetic model plus ED had ACU of 0.67 with a high specificity of 99.5% and low sensitivity of 5%. However, the PPV (positive predictive value) was 57.4%, much better than 9.5%. Findings: The readmission rate in the cohort declined from 11.8% to 9.5% over time indicate studied hospital has purposefully worked to decrease 30-day readmissions and have been successful among Hispanics with diabetes. Employment status: only 15% were employed, disabled (20%) had an adjusted odd of 2.43, retired (49%, adj 1.68) increased odds of readmission. The number of ED visits prior to admission was the strongest predictor ranging from an adjusted odd of 6.04 for 1 visit to 14.56 for 3 visits. The length of stay OR=1.75 for 4-6 days or an increase of 5% odds for every day in the hospital and smoking marginally increased odds of readmission. Receiving a consult for a home health aide at discharge was an important factor. Surprisingly, the diabetes complications code decreased the odds of 30-day readmission even though HgA1C above 9% did slightly increase odds. The majority were Spanish-speaking (69%), and 70% of all participants were seen by a diabetes nurse practitioner. Implications: Identified key factors of 30-day readmission among Hispanics with diabetes may lead to future targeted interventions effective in reducing readmissions in this population.
"]},{"key":"dc:title","label":"Title","values":["Factors Related to 30-Day Readmission among Hispanics with Type 2 Diabetes"]}]}],"canonical_facts":{"dc:creator":["Mohebbi, Athena"],"dc:date.available":["2021-11-17T08:00:00Z"],"dc:description.abstract":["Background: Medicare spends $17 billion yearly on 30-day readmissions. Hispanic adults have a higher prevalence of diabetes (12.6%) compared to non-Hispanic whites (9.4%). Those with a diagnosis of diabetes have the 17% higher rate (14-23%) for 30-day readmission. Little research has been conducted on Hispanics with diabetes relative to 30-day readmissions. Aims: Among Hispanics with type 2 diabetes: 1) measure the incidence of 30-day readmission by sociodemographic, behavioral and clinical factors;2) identify independent factors associated with 30-day readmission among Hispanic adults with type 2 diabetes accounting for potential covariates; 3) compare the ability of the Hispanic Diabetic Study Model plus ED, to the LACE model. Methods: The overall 30-day readmission rate for the three years of 14.7% (N=5985) and for those in the study cohort of 9.5% (N=3865). The Hispanic-Diabetic model plus ED had ACU of 0.67 with a high specificity of 99.5% and low sensitivity of 5%. However, the PPV (positive predictive value) was 57.4%, much better than 9.5%. Findings: The readmission rate in the cohort declined from 11.8% to 9.5% over time indicate studied hospital has purposefully worked to decrease 30-day readmissions and have been successful among Hispanics with diabetes. Employment status: only 15% were employed, disabled (20%) had an adjusted odd of 2.43, retired (49%, adj 1.68) increased odds of readmission. The number of ED visits prior to admission was the strongest predictor ranging from an adjusted odd of 6.04 for 1 visit to 14.56 for 3 visits. The length of stay OR=1.75 for 4-6 days or an increase of 5% odds for every day in the hospital and smoking marginally increased odds of readmission. Receiving a consult for a home health aide at discharge was an important factor. Surprisingly, the diabetes complications code decreased the odds of 30-day readmission even though HgA1C above 9% did slightly increase odds. The majority were Spanish-speaking (69%), and 70% of all participants were seen by a diabetes nurse practitioner. Implications: Identified key factors of 30-day readmission among Hispanics with diabetes may lead to future targeted interventions effective in reducing readmissions in this population.
"],"dc:identifier":["https://digital.sandiego.edu/dissertations/162"],"dc:subject":["Diabetes Nurse Practitioner","Family Practice Nursing","Other Nursing"],"dc:title":["Factors Related to 30-Day Readmission among Hispanics with Type 2 Diabetes"],"thesis:degree_discipline":["Nursing"],"thesis:degree_level":["Dissertation: Open Access"],"thesis:degree_name":["PhD Nursing"]},"updated_at":"2026-07-24T05:40:49Z"}