Use of Hospital-Based Rehabilitation Services and Hospital Readmission Following Ischemic Stroke in the United States.

This was an observational claims study, so it can show associations but not prove that PT, OT, or SLP therapy changed readmission. Medicare claims did not include direct stroke severity or functional status, which are strong reasons patients may receive more therapy and be readmitted. The sample was limited to fee-for-service Medicare beneficiaries aged 66 and older with ischemic stroke in 2010, so it does not cover younger patients, Medicare Advantage plans, or hemorrhagic stroke. Patients who died during the index stay, were discharged to hospice, or died within 30 days were excluded, so the findings do not describe those outcomes. Post-acute discharge destination was adjusted for but selection into skilled nursing, inpatient rehabilitation, or home health was not fully accounted for. Therapy amount was used as a proxy for intensity, and the content of therapy was not measured. The analysis did not include Part B claims, outpatient visits, or other transitional care that may influence readmission. When transferred patients were added, one demographic finding changed, with higher odds of readmission for Black patients, so some results may be sensitive to sample choices.

No conflict of interest was declared. Publication types include Research Support, N.I.H., Extramural and Research Support, Non-U.S. Gov't.

Do not read this as proof that hospital physical therapy prevents readmission. The study is observational, could not account for stroke severity or function, and found no significant association for occupational therapy or speech-language pathology therapy.