Functional Status Is Associated With 30-Day Potentially Preventable Hospital Readmissions After Inpatient Rehabilitation Among Aged Medicare Fee-for-Service Beneficiaries.
Addie Middleton, James E Graham, Kenneth J Ottenbacher
PMID 28583465WHAT IT FOUND
Patients with greater independence in self-care, mobility, and cognition at discharge had lower odds of 30-day potentially preventable readmission.
Those in the highest functional quartiles had 30% to 36% lower adjusted odds than those in the lowest quartiles.
Key findings
01Higher functional status at discharge was associated with lower adjusted odds of 30-day potentially preventable readmissions: self-care 0.70, mobility 0.64, and cognition 0.84 when comparing the highest to lowest quartiles.
02Infection-related conditions accounted for 44.1% of potentially preventable readmissions, followed by chronic conditions at 31.2% and other unplanned events at 24.7%.
03The study found an association but did not prove that improving functional independence reduces readmission rates.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study is observational and cannot prove that improving functional status reduces readmissions. Data lacked information on caregiver availability and other social factors that influence readmission risk. The cohort was restricted to Medicare fee-for-service beneficiaries aged 66 and older who survived 32 days post-discharge, limiting generalizability to younger or sicker populations. The definition of 'potentially preventable' relies on a specific list of diagnoses that may include some unavoidable readmissions.
Declared interests
The study was supported by the National Institute on Disability, Independent Living, and Rehabilitation Research and the National Institute of Child Health and Human Development. The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that improving a patient's functional score will directly lower their readmission risk. This study shows an association between discharge status and readmission rates, but it did not test whether interventions to improve function actually prevent readmissions.