Longitudinal Analysis of Hospitalization After Spinal Cord Injury: Variation Based on Race and Ethnicity

Mahmoudi, Elham; Forchheimer, Martin; Fyffe, Denise; Krause, James S.; Tate, Denise G.

doi:10.1016/j.apmr.2014.07.399

Cited by 25 publications

(14 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consistent with previous research, we found that lower FIM motor score was significantly associated with increased risk of hospital readmission. 13,14,16,17 Our findings suggest that individuals who primarily use a manual or power wheelchair (proxy measure of higher level of impairment) are more likely to be readmitted multiple times than individuals who do not use a wheelchair. This is likely due to the fact that the individuals who do not use a wheelchair are typically ambulatory, and therefore higher functioning.…”

Section: Function and Injury Levelmentioning

confidence: 82%

“…In addition, ANOVA analysis indicated that FIM motor scores at admission (F(2,1167)=6.62, p<0.001), discharge (F(2,1167)=28.80, p<0.001), and one-year follow-up (F(2,1107)=45.27, p<0.001), number of days from injury to initial IRF admission (F(2,1167)=15. 16 readmissions. Individuals with no readmissions also had fewer days from initial injury to IRF admission than individuals with single (p<0.001) and multiple readmissions (p<0.001).…”

Section: Resultsmentioning

confidence: 99%

“…15 Studies on health care utilization following SCI have shown that discharge functional status, comorbidities, previous hospitalizations, enrollment in Medicare or Medicaid as their primary insurance provider, and length of stay at IRF were independent contributors to readmission rates. 14,[16][17][18] Efforts to improve the continuum of care to reduce readmissions after SCI have been multidimensional. However, Stillman et al 19 identified barriers for patients with SCI in 76.9% of primary care offices that participated in their study.…”

Section: Introductionmentioning

confidence: 99%

“…A secondary objective of this study was to evaluate the effect of genitourinary, respiratory, and skin conditions on multiple readmissions in this population, because these conditions are preventable and common contributors to single readmissions. 13,14 Based on prior research, 6,8,10,[12][13][14][15][16][17][18][19][20][21] we hypothesized that psychosocial risk factors and lower utilization of rehabilitation services would be associated with multiple readmissions within one year of discharge from an IRF.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Factors Associated with Multiple Hospital Readmissions for Individuals with Spinal Cord Injury

Canori

Kumar

Hiremath

2020

View full text Add to dashboard Cite

Objective: To identify patient-level and clinical factors associated with multiple hospital readmissions in individuals with spinal cord injury (SCI). Design: Retrospective cohort analysis of the publicly available dataset from the SCI Rehabilitation (SCIRehab) study. Setting: Six rehabilitation centers in the U.S. that participated in the SCIRehab study. Participants: Individuals with traumatic SCI (N=1371) who were consecutively enrolled in the SCIRehab study. Outcome measures: The primary outcome was all-cause hospital readmission within 1 year of discharge from a rehabilitation center. The patient-level and clinical factors include employment status, depression, caregiver support, state-funded insurance, functional status, and rehabilitation services. Results: Of the 1170 participants included in the study, 228 were readmitted once and 120 were readmitted multiple times. In our study, 34.2% and 10.8% were readmitted more than once due to genitourinary and respiratory conditions, respectively. Lower utilization of rehabilitation services, lower functional status, unemployment, and depression were associated with higher odds of being readmitted multiple times within one year of discharge from inpatient rehabilitation facility. Conclusion: Psychosocial and clinical factors were associated with increased risk for multiple readmissions in individuals with SCI. In order to reduce recurrent readmissions in individuals with SCI, further research is necessary to maximize efficacy of risk factor modification and prevention strategies.

show abstract

Section: Function and Injury Levelmentioning

confidence: 82%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Factors Associated with Multiple Hospital Readmissions for Individuals with Spinal Cord Injury

Canori

Kumar

Hiremath

2020

View full text Add to dashboard Cite

show abstract

“…This value likely underestimates the true rate as patients lost to follow-up were excluded and only readmissions back to the same health system were captured. Mahmoudi et al 27 examined SCI model systems network data from 1990–2000 and reported an overall 1-year rehospitalization rate of 31%. However, hospital admissions were obtained through patient self report and these authors acknowledged the inherent problems with patients lost to follow-up in prospective longitudinal studies.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Investigation of Rehospitalization Patterns in Spinal Cord Injury and Traumatic Brain Injury Among Medicare Beneficiaries

Pretz

Graham

Middleton

et al. 2017

Archives of Physical Medicine and Rehabilitation

View full text Add to dashboard Cite

Objective To model 12-month rehospitalization risk among Medicare beneficiaries receiving inpatient rehabilitation for SCI or TBI and to create two (SCI- and TBI-specific) interactive tools enabling users to generate monthly projected probabilities for rehospitalization based on an individual patient’s clinical profile at discharge from inpatient rehabilitation. Design Secondary data analysis. Setting More than 1,100 inpatient rehabilitation facilities across the US. Participants Medicare beneficiaries receiving inpatient rehabilitation for SCI or TBI. Main Outcome Measure Monthly rehospitalization (yes/no) based on Medicare claims. Results Results are summarized through computer-generated interactive tools, which plot individual level trajectories of rehospitalization probabilities over time. Factors associated with the probability of rehospitalization over time are also provided, with different combinations of these factors generating different individual level trajectories. Four case studies are presented to demonstrate the variability in individual risk trajectories. Monthly rehospitalization probabilities for the individual high-risk TBI and SCI cases declined from 33–15% and 41–18%, respectively, over time, whereas the probabilities for the individual low-risk cases were much lower and stable over time: 5–2% and 6–2%, respectively. Conclusion Rehospitalization is an undesirable and multifaceted health outcome. Classifying patients into meaningful risk strata at different stages of their recovery is a positive step forward in anticipating and managing their unique healthcare needs over time.

show abstract

Disparities in Health Care for Black Patients in Physical Medicine and Rehabilitation in the United States: A Narrative Review

Odonkor

Esparza

Flores

et al. 2020

PM&R

View full text Add to dashboard Cite

Racial health disparities continue to disproportionately affect Black persons in the United States. Black individuals also have increased risk of worse outcomes associated with social determinants of health including socioeconomic factors such as income, education, and employment. This narrative review included studies originally spanning a period of approximately one decade (December 2009‐December 2019) from online databases and with subsequent updates though June 2020. The findings to date suggest pervasive inequities across common conditions and injuries in physical medicine and rehabilitation for this group compared to other racial/ethnic groups. We found health disparities across several domains for Black persons with stroke, traumatic brain injury, spinal cord injury, hip/knee osteoarthritis, and fractures, as well as cardiovascular and pulmonary disease. Although more research is needed, some contributing factors include low access to rehabilitation care, fewer referrals, lower utilization rates, perceived bias, and more self‐reliance, even after adjusting for hospital characteristics, age, disease severity, and relevant socioeconomic variables. Some studies found that Black individuals were less likely to receive care that was concordant with clinical guidelines per the reported literature. Our review highlights many gaps in the literature on racial disparities that are particularly notable in cardiac, pulmonary, and critical care rehabilitation. Clinicians, researchers, and policy makers should therefore consider race and ethnicity as important factors as we strive to optimize rehabilitation care for an increasingly diverse U.S. population.

show abstract

Longitudinal Analysis of Hospitalization After Spinal Cord Injury: Variation Based on Race and Ethnicity

Cited by 25 publications

References 18 publications

Factors Associated with Multiple Hospital Readmissions for Individuals with Spinal Cord Injury

Factors Associated with Multiple Hospital Readmissions for Individuals with Spinal Cord Injury

Longitudinal Investigation of Rehospitalization Patterns in Spinal Cord Injury and Traumatic Brain Injury Among Medicare Beneficiaries

Disparities in Health Care for Black Patients in Physical Medicine and Rehabilitation in the United States: A Narrative Review

Contact Info

Product

Resources

About