What is the clinical evidence from this study?

Study design: Cohort. Population: Deconditioning and medically complex diagnoses at high risk for hospital readmission (n=25908). Intervention: Change in FIM motor scale ratings vs. Lower change in FIM motor scale ratings. Primary outcome: 30-day unplanned hospital readmission (OR 0.958, 95% CI 0.955-0.960).

September 10, 2015Physical TherapyOpen Access

Predictors of 30-Day Readmission Following Inpatient Rehabilitation for Patients at High Risk for Hospital Readmission

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Key result

Greater improvement in motor functional status during inpatient rehabilitation was associated with a lower risk of 30-day hospital readmission (OR 0.958 per 1-point change) among high-risk patients.

Population

25,908 Medicare patients in the highest risk quartile for readmission who were deconditioned and had…

Design

Cohort

Follow-up

30-day

Authors

SFSteve FisherCommonwealth Scientific and Industrial Research Organisation JGJames E. GrahamUnited States Fish and Wildlife Service SKShilpa KrishnanIndian Institute of Technology Guwahati

Discussion

Member takes

Implication

May support functional gains for readmission risk stratification in postacute rehab; leaves open causal effects and intervention trials.

Study Design

Type

Cohort (n=25,908)

Multicenter

Yes

Structured PICO

Population

25,908 older Medicare beneficiaries with deconditioning and medically complex diagnoses at high risk for readmission, followed for 30 days post-discharge from inpatient rehabilitation.

Outcome

30-day all-cause unplanned readmission to an acute care hospitalhard clinical

Main Result

Odds Ratio: 0.958 (95% CI 0.955–0.96)

For older patients admitted to postacute inpatient rehabilitation, functional status measures and rehabilitation length of stay can help clinicians further stratify the risk of 30-day hospital readmission.

Limitations

Limited to variables for billing and administrative functions, lacking information on health behaviors, nutrition, or education level.
Only patients in the Medicare fee-for-service plan were included, limiting generalizability to Medicare Advantage plans.
Potentially preventable readmissions were not distinguished from unpreventable readmissions.
Lacked information on the type or quality of care patients received following discharge from inpatient rehabilitation.
Although planned readmissions were accounted for in the outcome, potentially preventable readmissions were not distinguished from unpreventable readmissions.

Cite This Study

Fisher et al. (2015) conducted a cohort in Deconditioning and medically complex diagnoses at high risk for hospital readmission (n=25,908). Change in FIM motor scale ratings vs. Lower change in FIM motor scale ratings was evaluated on 30-day unplanned hospital readmission (OR 0.958, 95% CI 0.955-0.960). Greater improvement in motor functional status during inpatient rehabilitation was associated with a lower risk of 30-day hospital readmission (OR 0.958 per 1-point change) among high-risk patients.

synapsesocial.com/papers/6a9c6a2d5a6c7c49fc98f87f https://doi.org/10.2522/ptj.20150034

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Predictors of 30-Day Readmission Following Inpatient Rehabilitation for Patients at High Risk for Hospital Readmission

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Predictors of 30-Day Readmission Following Inpatient Rehabilitation for Patients at High Risk for Hospital Readmission

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider