Preventative Services Use and Risk Reduction for Potentially Preventative Hospitalizations Among People With Traumatic Spinal Cord Injury

Mahmoudi, Elham; Lin, Paul S.; Ratakonda, Samantha; Khan, Anam; Kamdar, Neil; Peterson, Mark D.

doi:10.1016/j.apmr.2021.12.004

Cited by 7 publications

(7 citation statements)

References 40 publications

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“…According to the NSCISC, the average length of rehospitalization stay during the rst year of injury is 23 days (1) . The most common reasons for rehospitalization were urinary tract infections (UTI), respiratory infections, pressure injuries (PI), and digestive problems (3) , all of which are considered preventable (4) . Previous studies have found that race/ethnicity (5,6) , injury severity (2,6) , education (6) , employment (5) , income (6) , and aging (6) are all linked with rehospitalization.…”

Section: Introductionmentioning

confidence: 99%

Utilization of Machine A Learning Algorithm in the Prediction of Rehospitalization During One-Year Post-Traumatic Spinal Cord Injury

Aly,

Chen,

Ahmed

et al. 2024

Preprint

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Study design: Retrospective cohort study Objective: The primary aim was to develop a machine learning (ML) model to predict rehospitalization during the first year of traumatic spinal cord injury (TSCI) and to identify top predictors using data obtained during initial rehabilitation. The secondary aim was to predict prolonged hospital stay among the rehospitalized group. Setting: Eighteen SCI Model Systems centers throughout the United States. Methods: Data were retrieved from the National Spinal Cord Injury Model Systems Database. The participants were divided into 2 groups based on rehospitalization during first year of injury. Those who experienced rehospitalization during first year were further grouped into prolonged stay (> 75th quartile of total length of stay) or non-prolonged stay. Variables considered in models included socio-demographic factors, clinical characteristics, and comorbidities. Results: The best performing classification models were Random Forest for predicting rehospitalization and Adaptive Boosting for prolonged stay. The most important predictors in both models were Functional Independence Measure (FIM) motor score, American Spinal Injury Association (ASIA) scores, age, days from injury to rehabilitation admission and body mass index. Additionally, for prolonged stays, pressure injury as a reason of rehospitalization was top predictor. Conclusion: The crucial role of factors such as FIM and ASIA scores emerge as pivotal predictors of both rehospitalizations and prolonged rehospitalizations, might guide clinicians in risk assessment. Furthermore, identification of pressure injury as primary predictor for prolonged stays signifies a targeted focus on preventive measures for pressure injury-related rehospitalizations, offering a specific strategy to enhance patient care and outcomes.

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Section: Introductionmentioning

confidence: 99%

Utilization of Machine A Learning Algorithm in the Prediction of Rehospitalization During One-Year Post-Traumatic Spinal Cord Injury

Aly,

Chen,

Ahmed

et al. 2024

Preprint

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“…Patients with disabilities are at higher risk for multimorbidity and adverse health events than the general population. [12][13][14][15] Furthermore, systematic racism 16 -economic deprivation, provider bias, and living in segregated/disadvantaged areas-makes it more challenging for some racial/ethnic subpopulations of adults with disabilities to access preventive care. 17,18 As the lifespan of individuals with congenital disabilities increases, timely access to preventive services plays a critical role in maintaining health and independence.…”

Section: Introductionmentioning

confidence: 99%

Racial and Ethnic Inequities in Use of Preventive Services Among Privately Insured Adults With a Pediatric-Onset Disability

et al. 2022

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PURPOSE Cerebral palsy (CP) and spina bifida (SB) are pediatric-onset disabilities. Adults living with CP/SB are in a greater need of preventive care than the general population due to their increased risk for chronic diseases. Our objective was to compare White/Black and White/Hispanic inequities in the use of preventive services. METHODSUsing 2007-2017 private claims data, we identified a total of 11,635 adults with CP/BS. Of these, 8,935 were White, 1,457 Black, and 1,243 Hispanic. We matched healthrelated variables (age, sex, comorbid conditions) between White adults and those in each minority subpopulation. Generalized estimating equations were used and all models were adjusted for age, sex, comorbidities, income, education, and US Census divisions. Outcomes of interest were: (1) any office visit; (2) any physical/occupational therapy; (3) wellness visit; (4) bone density screening; (5) cholesterol screening; and (6) diabetes screening. RESULTSThe rate of recommended services for all subpopulations of adults with CP/SB was low. Compared with White adults, Hispanic adults had lower odds of wellness visits (odds ratio [OR] = 0.71, 95% CI, 0.53-0.96) but higher odds of diabetes screening (OR = 1.48, 95% CI, 1.13-1.93). Compared with White adults, Black adults had lower odds of wellness visits (OR = 0.50, 95% CI, 0.24-1.00) and bone density screening (OR = 0.54, 95% CI, 0.31-0.95). CONCLUSIONS Preventive service use among adults with CP/SB was low. Large Whiteminority disparities in wellness visits were observed. Interventions to address physical accessibility, adoption of telehealth, and increased clinician education may mitigate these disparities, particularly if initiatives target minority populations.

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“…4 Another recent study found that the PPR rate for stroke patients was 9.84% after 30 days and 30.65% after 1 yr. 2 Similarly, patients who experienced a spinal cord injury (SCI) had an all-cause readmission rate of 18% over 4 yrs 5 and were more likely to have a preventable hospital admission due to a urinary tract infection, hypertension, long-term diabetes complications, or pneumonia. 6 Reviewing each individual PPR is a standard quality procedure at our IRF; however, this is typically done on a case-by-case basis. The goal of this analysis was to compile all our PPR cases and compare them with a control group to explore common characteristics, identify the high-risk populations, and reveal predictors of PPRs.…”

mentioning

confidence: 99%

“…Another recent study found that the PPR rate for stroke patients was 9.84% after 30 days and 30.65% after 1 yr 2 . Similarly, patients who experienced a spinal cord injury (SCI) had an all-cause readmission rate of 18% over 4 yrs 5 and were more likely to have a preventable hospital admission due to a urinary tract infection, hypertension, long-term diabetes complications, or pneumonia 6 …”

mentioning

confidence: 99%

Potentially Preventable Readmissions after Acute Inpatient Rehabilitation

Herrmann

Chrenka

Seth

et al. 2023

Am J Phys Med Rehabil

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Objective The aim of the study is to identify causes and risk factors for potentially preventable readmissions of patients discharged from an inpatient rehabilitation facility. Design Our hospital billing database was used to identify patients discharged from our inpatient rehabilitation facility between 2013 and 2018 and experienced a potentially preventable readmission within 90 days (n = 75). Retrospective chart review was completed to obtain clinical data. Of the patients discharged from the inpatient rehabilitation facility who did not experience a potentially preventable readmission, a group of age- and sex-matched controls (n = 75) was randomly selected. The two study groups were compared using univariate and multivariate analyses. Results Our study found that individuals who discharged from acute inpatient rehabilitation were more likely to be readmitted with a potentially preventable readmission if they have a greater number of comorbidities, were admitted initially with a spinal cord injury, or have lower admission or discharge Functional Independence Measure motor scores. The most common potentially preventable readmission diagnoses were sepsis, renal failure, respiratory problems, and urinary tract infection. Conclusions Identifying patients with the common causes for potentially preventable readmissions, in addition to the noted risk factors, is an important consideration for inpatient rehabilitation discharge planning.

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Preventative Services Use and Risk Reduction for Potentially Preventative Hospitalizations Among People With Traumatic Spinal Cord Injury

Cited by 7 publications

References 40 publications

Utilization of Machine A Learning Algorithm in the Prediction of Rehospitalization During One-Year Post-Traumatic Spinal Cord Injury

Utilization of Machine A Learning Algorithm in the Prediction of Rehospitalization During One-Year Post-Traumatic Spinal Cord Injury

Racial and Ethnic Inequities in Use of Preventive Services Among Privately Insured Adults With a Pediatric-Onset Disability

Potentially Preventable Readmissions after Acute Inpatient Rehabilitation

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