Potentially Preventable Within-Stay Readmissions Among Medicare Fee-for-Service Beneficiaries Receiving Inpatient Rehabilitation.
Addie Middleton, James E Graham, Anne Deutsch and 1 others
PMID 28477958WHAT IT FOUND
During inpatient rehabilitation, 3.5% of Medicare stays were readmitted for conditions considered potentially preventable.
Older age, male sex, prior hospitalizations, long acute stay, ICU use, more comorbidities, and lower function marked higher risk. Infections accounted for 36.8% of these readmissions.
Key findings
01The national rate of potentially preventable within stay readmissions was 3.5%.
02Older age, male sex, more prior hospitalizations, longer index hospital stay, intensive care use, more comorbidities, and lower functional independence at admission were associated with higher odds of potentially preventable within stay readmission.
03Infections accounted for 36.8% of potentially preventable readmissions, and inadequate injury prevention accounted for 6.1%.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study used administrative Medicare claims, so it could not verify the accuracy of data entry or capture information not submitted to CMS. It included only patients with inpatient rehabilitation stays of 3 to 45 days and hospital stays of 30 days or less, so it may exclude sicker patients or those with longer stays. The analysis is largely descriptive and observational, so it cannot show that any treatment, monitoring approach, or therapy caused fewer readmissions. The authors could not determine infection onset or mechanism from claims data, so it is unclear whether infections began in the hospital or during rehabilitation. Sociodemographic information was limited, so findings about race, ethnicity, dual eligibility, and disability entitlement should be interpreted cautiously.
The easy way to misread this
Do not read the 3.5% rate or the associated risk factors as evidence that a specific treatment prevents readmission. The study is an administrative analysis of Medicare records and did not test an intervention.