Do Psychosocial Factors Predict Readmission among Diabetic Elderly Patients?

Mousa Alavi, Omeleila Baharlooei, Marzieh AdelMehraban


Background: Despite advances in diabetes treatment, the rate of readmission is still relatively high among these patients, especially in older population. Various factors may predict readmission in these patients; hence, the aim of this study was to assess the role of psychosocial factors in predicting readmission among diabetic elderly hospitalized in selected hospitals of Isfahan.
Materials and Methods: In this cross‑sectional study conducted from January to September 2016, 150 diabetic elderly hospitalized in selected hospitals affiliated with Isfahan University of medical sciences were chosen using a convenient sampling method. The initial information was collected by a three‑part questionnaire consisting of (a) demographic characteristics, (b) 21‑item depression, anxiety, and stress scale (DASS‑21), and (c) multidimensional scale of perceived social support (MSPSS). Further information about readmission was gathered 3 months after completing the questionnaires through a phone call follow‑up. Descriptive and inferential statistics (discriminant function analysis test) were used to analyze the data.

Results: During 3 months after discharge, 44% of hospitalized diabetic elderly were readmitted. Analytical model predicted the readmission status of 109 individuals (of total 150 persons) in the studied units (success rate of 72.2%). Among predicting factors, depression and social support had the most and the least important roles in predicting readmission rate, respectively.

Conclusions: Interventions to improve mental status (i.e., decreasing levels of depression, anxiety, and stress) and develop social support are suggested to reduce the risk of readmission among diabetic elderly patients. Nevertheless, future studies are needed to verify the value of such interventions.


Aged; patient readmission; psychosocial factors

Full Text:



Pahlavanzadeh F, Jarolahi O. The impact of social factors on mental health of rural elderly. Rural Dev 2011;3:65 84.

Barati M, Fathi Y, Soltanian AR, Moeini B. Mental health condition and health promoting behaviors among elders in Hamadan Scientific. J Hamadan Nurs Midwifery Fac 2012;20:12 9.

Mokhtari M, Bahram ME, Pourvaghar MJ, Akasheh G. Effect of Pilates training on some psychological and social factors related to falling in elderly women. Feiz 2013;17:453 62.

Arastoo A, Ghasemzade R, Nasseh H, Kamali M, Rahimi Foroshani A, Arzaghi M, et al. Factors affecting quality of life in elderly diabetic residents of the Kahrizak geriatric nursing home of Tehran. Iran J Endocrinol Metab 2012;14:18 24.

Tabatabai O, Peymani M, Heshmat R, Pajhohi M. Quality of care of diabetes in old age diabetic patients in diabetes clinic of Shariati hospital. Iran J Diabetes Lipid Disord 2010;10:161 9.

Comino EJ, Harris MF, Islam MF, Tran DT, Jalaludin B, Jorm L, et al. Impact of diabetes on hospital admission and length of stay among a general population aged 45 year or more: A record linkage study. BMC Health Serv Res 2015;15:1 13.

Nobili A, Licata G, Salerno F, Pasina L, Tettamanti M, Franchi C, et al. Polypharmacy, length of hospital stay, and in hospital mortality among elderly patients in internal medicine wards: The REPOSI study. Eur J Clin Pharmacol 2011;67:507 19.

Franchi C, Nobili A, Mari D, Tettamanti M, Djade CD, Pasina L, et al. Risk factors for hospital readmission of elderly patients. Eur J Intern Med 2013;24:45 51.

Reed JF, Bokovoy JL, Doram KR. Unplanned readmissions after hospital discharge among heart failure patients at risk for 30 day readmission using an administrative dataset and “off the shelf” readmission models. Internet J Cardiovasc Res 2014;9.

Silverstein MD, Qin H, Mercer SQ, Fong J, Haydar Z. Risk factors for 30 day hospital readmission in patients ≥65 years of age. Proceedings (Baylor University Medical Center) 2008;21:363 72.

Rubin DJ. Hospital readmission of patients with diabetes. Curr Diabetes Rep 2015;15:1 9.

Collins McNeil JC, Holston EC, Edwards CL, Benbow D, Ford Y. Physical activity, depressive symptoms, and social support among African American women with type 2 diabetes. McGill Univ Sch Nurs 2009;41:24 43.

Dattalo P. Determining Sample Size: Balancing Power, Precision, and Practicality, Oxford: Oxford University Press; 2008. pp. 30.

Low LL, Liu N, Wang S, Thumboo J, Ong MEH, Lee KH. Predicting frequent hospital admission risk in Singapore: A retrospective cohort study to investigate the impact of comorbidities, acute illness burden and social determinants of

health. BMJ Open 2016;6:e012705.

Samani S, Jokar B. Validity and reliability short form version of the Depression, Anxiety and Stress. J Humanities Soc Sci Shiraz Univ 2007;26:65 77.

Chenari R, Norozi A, Tahmasebi R. The relationship between perceived social support with health promotion behaviors in veterans of Ilam, 2012 2013. Iran J War Public Health 2013;21:1 10.

Mudge AM, Kasper K, Clair A, Redfern H, Bell JJ, Barras MA, et al. Recurrent readmissions in medical patients: A prospective study. J Hosp Med 2011;6:61 7.

Garrison MM, Katon WJ, Richardson LP. The impact of psychiatric comorbidities on readmissions for diabetes in youth. Diabetes Care 2005;28:2150 4.

Mazloom Bafrooi N, Dehghani Firouzabadi T, Alizade B. Prevalence of depression and anxiety in patients with diabetes.J Diabetes Nurs Midwifery Zabol 2014;2:60 8.

Bhoraskar A. Inpatient management of diabetes mellitus. J Assoc Phys India 2011;59:29 31.

Moses A. Stress Hyperglycemia. The Association of Physicians of India 2013;38:178 81. Available from: http://www.apiindia. org/medicine_update_2013/chap38.pdf. [Last Accessed on 2017 Apr 09].

Ranabir S, Reetu K. Stress and hormones. Indian J Endocrinology Metab 2011;15:18 22.

Strunin L, Stone M, Jack B. Understanding rehospitalization risk: Can hospital discharge be modified to reduce recurrent hospitalization? J Hosp Med 2007;2:297 304.

Hu J, Gonsahn MD, Nerenz DR. Socioeconomic status and readmissions: Evidence from an urban teaching hospital. Health

Affairs 2014;33:778 85


  • There are currently no refbacks.