Determinants of health after hospital discharge: rationale and design of the Vanderbilt Inpatient Cohort Study (VICS)
Year: 2014
Type: article
Study design: Study Protocol
Abstract: 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.
Source: BMC Health Services Research
Institutions: Vanderbilt University, VA Tennessee Valley Healthcare System
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,573
Funders: U.S. Department of Veterans Affairs, Health Services Research and Development, National Institutes of Health, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Advancing Translational Sciences, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G1182793083, Leveraging Patient Portals to Improve Medication Adherence in Type 2 Diabetes, G2265622010, G2759730755, Training in Cardiovascular Research, Predicting Acute Brain Dysfunction in Older Patients: A Quality Improvement Tool, G5253921404, Building Interdisciplinary Research Careers in Women's Health, G6988210397, The Vanderbilt Institute for Clinical and Translational Research (VICTR), Health Literacy, Hospital Discharge, and Cardiovascular Outcomes, G9000033427
OpenAlex ID: W1971344046