While many barriers are fundamental and cannot be removed, at least some can be addressed through the enhancement of the system of care. Furthermore, successful facilitators could be expanded. Conclusions: Reduction of barriers and enhancement of facilitators have the potential to increase receipt of timely medical care for diverse immigrants who have tested positive for viral hepatitis. One potential intervention to reduce barriers includes patient navigators (PNs) or health advocates. Specifically, culturally targeted PNs have shown success in working with foreign-born communities with chronic illnesses. This initial study suggests that modifications of the health care system might offer
promise Galunisertib research buy for improved care for individuals from immigrant communities Pembrolizumab order who have viral hepatitis and are at increased risk of liver cancer. Disclosures: The following people have nothing to disclose: Hyosun Han, Ponni Perumal-swami, Lawrence Kleinman, Lina Jandorf BACKGROUND: Rehospitalization following liver transplantation (LT) is a costly and often preventable event. Cardiovascular disease (CVD) is a leading cause of post-LT morbidity, but little is known about CVD-related rehospitalization. Therefore, we examined the prevalence and predictors of CVD-related rehospitalization after LT. METHODS: Adult recipients
of a primary LT (ICD-9 V42.7) were identified within the University HealthSystem Consortium database from 10/2009–3/2013. We excluded those who died (n=571) or were transferred to another facility (n=496) during the index LT hospitalization. Pre-transplant ICD-9-CM codes from billing claims were used for comorbidity adjustment. Logistic regression modeling determined predictors of 30- and 90-day CVD-related rehospitalization, Dynein defined as arterial/pulmonary embolism, arrhythmia, heart failure (HF),
myocardial infarction (MI), angina, hypertension, pulmonary hypertension, peripheral vascular disease and/or stroke. RESULTS: We identified 12,826 patients (70.6% white, 66.2% male) with 2,1 15 readmissions within 30d of LT and 4,287 readmissions within 90d. Of these, CVD contributed to 1,030 (48.7%) of 30d readmissions and 2,255 (52.6%) of 90d readmissions. Yet, baseline CVD was present in only 4.4% (564/12,826) of all LT recipients during the index hospitalization. Ischemic heart disease (MI or angina) accounted for <1% of 30d readmissions. Hypertension was listed as a comorbid condition in 40.1% of all 30d readmissions, followed by arrhythmia (8.7%) and HF (3.0%). Patients readmitted with CVD were older (56.0 vs. 52.0 years) and more likely to be black (12.1% vs. 9.6%). They also had a shorter index LT hospitalization (12.0 vs. 20.2 days) and intensive care unit (3.8 vs. 7.5 days) stay. The factors associated with 30d CVD readmission were age (per year) (OR=1.01, 95% CI: 1.001–1.