干旱区生态环境知识资源中心(Arid): Functional Status Across Post-Acute Settings is Associated With 30-Day and 90-Day Hospital Readmissions

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DOI	10.1016/j.jamda.2021.07.039
	Functional Status Across Post-Acute Settings is Associated With 30-Day and 90-Day Hospital Readmissions
	Li, Chih-Ying; Haas, Allen; Pritchard, Kevin T.; Karmarkar, Amol; Kuo, Yong-Fang; Hreha, Kimberly; Ottenbacher, Kenneth J.
通讯作者	Li, CY (corresponding author), Rm 3-906,301 Univ Blvd, Galveston, TX 77555 USA.
来源期刊	JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
ISSN	1525-8610
EISSN	1538-9375
出版年	2021
卷号	22 期号:12 页码:2447-+
英文摘要	Objective: To examine the association between cocalibrated functional scores across post-acute care settings and the subsequent risk of hospital readmission. Design: Retrospective cohort study. Setting and Participants: We analyzed 781,021 fee-for-service Medicare beneficiaries discharged to either inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), or home health agencies (HHA) after an acute hospital stay for stroke (N = 143,277), lower extremity joint replacements (512,577), and hip/femur fracture (125,167) between January 1, 2013, and August 31, 2014. Measures: Functional items from IRF-PAI, MDS, and OASIS were categorized into self-care and mobility domains. We cocalibrated admission functional scores across post-acute settings and divided scores into 4 functional levels using quartiles (Q1-Q4, with Q4 representing the most independent function). The primary outcomes were 30-day and 90-day hospital readmissions (yes/no) after an initial post-acute stay. Results: Patients who were more dependent in self-care and mobility at the initial post-acute setting were significantly more likely to experience hospital readmission [eg, hazard ratios of 30-day readmission in stroke: 1.54 (95% confidence interval [CI] 1.47-1.61), 1.18 (95% CI 1.14-1.23), and 1.12 (95% CI 1.08-1.16) for Q1, Q2 and Q3, compared to Q4]. We found similar results for risk of 90-day hospital readmission across impairment conditions. Conclusions and Implications: Patients who were more functionally dependent at the initial post-acute setting had a higher risk to readmit to the hospitals after discharging from the post-acute setting for 30 and 90 days, compared with patients who were more functionally independent. This finding is consistent across impairment conditions and post-acute settings. Future research should determine effective strategies of maintaining and facilitating functional performance across post-acute settings to optimize long-term patient outcomes. (C) 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
英文关键词	Subacute care patient readmission mobility self-care transitional care continuity of patient care
类型	Article
语种	英语
收录类别	SCI-E ; SSCI
WOS记录号	WOS:000722129900007
WOS关键词	RISK-FACTORS ; CARE ; MOBILITY ; INDEPENDENCE ; CROSSWALK ; CONTINUUM ; IMPACT
WOS类目	Geriatrics & Gerontology
WOS研究方向	Geriatrics & Gerontology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/374070
作者单位	[Li, Chih-Ying] Univ Texas Med Branch, Dept Occupat Therapy, Galveston, TX 77555 USA; [Haas, Allen; Kuo, Yong-Fang] Univ Texas Med Branch, Dept Prevent Med & Populat Hlth, Galveston, TX 77555 USA; [Pritchard, Kevin T.; Hreha, Kimberly; Ottenbacher, Kenneth J.] Univ Texas Med Branch, Div Rehabil Sci, Galveston, TX 77555 USA; [Karmarkar, Amol] Virginia Commonwealth Univ, Dept Phys Med & Rehabil, Richmond, VA USA; [Karmarkar, Amol] Sheltering Arms Inst, 2000 Wilkes Ridge Pl Dr, Richmond, VA USA; [Kuo, Yong-Fang; Ottenbacher, Kenneth J.] Univ Texas Med Branch, Sealy Ctr Aging, Galveston, TX 77555 USA
推荐引用方式 GB/T 7714	Li, Chih-Ying,Haas, Allen,Pritchard, Kevin T.,et al. Functional Status Across Post-Acute Settings is Associated With 30-Day and 90-Day Hospital Readmissions[J],2021,22(12):2447-+.
APA	Li, Chih-Ying.,Haas, Allen.,Pritchard, Kevin T..,Karmarkar, Amol.,Kuo, Yong-Fang.,...&Ottenbacher, Kenneth J..(2021).Functional Status Across Post-Acute Settings is Associated With 30-Day and 90-Day Hospital Readmissions.JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION,22(12),2447-+.
MLA	Li, Chih-Ying,et al."Functional Status Across Post-Acute Settings is Associated With 30-Day and 90-Day Hospital Readmissions".JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION 22.12(2021):2447-+.