Variation in 30-Day Readmission Rates from Inpatient Rehabilitation Facilities to Acute Care Hospitals

Shea, Cristina; Turcu, Razvan P.; Wong, Bonny S.; Brassil, Michelle E.; Slocum, Chloe; Goldstein, Richard; Zafonte, Ross; Shih, Shirley L; Schneider, Jeffrey C.

doi:10.1016/j.jamda.2021.03.033

Cited by 4 publications

(6 citation statements)

References 24 publications

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“…A study by Shea et al also found amputation to be one of the impairment groups admitted to IRFs that carried a significantly higher risk of readmission to acute care hospitals within the first 30 days of rehabilitation stay. 22 However, Shea et al observed a readmission rate of 11.5% for patients with amputation, which was significantly lower than the rate in our study (p = .006). The difference between the rates is likely multifactorial.…”

Section: Discussioncontrasting

confidence: 88%

Risk factors for readmission of patients with amputation to acute care from inpatient rehabilitation: A retrospective cohort study

Chang

Lopez

Mei

et al. 2023

PM&R

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IntroductionAmputation is a major condition that requires inpatient rehabilitation. Some research has been conducted to explore the risk factors for readmission of patients from inpatient rehabilitation facilities to acute care hospitals. However, few studies have included patients with amputation in the study population.ObjectiveThis study aimed to identify the risk factors for readmission of patients with amputation to acute care hospitals from an inpatient rehabilitation facility.DesignRetrospective cohort study.SettingAn acute rehabilitation hospital associated with a community‐based tertiary medical center.PatientsA retrospective review of 156 independent admissions of 145 patients from June 2019 to July 2022.Main Outcome MeasureThe study outcome measure was readmission to acute care from an acute rehabilitation unit.ResultsOf the 156 independent admissions, the readmission rate was 19%(29/156). The most common cause of transfer was incision‐site complications (9/29, 31%) including wound infection and wound dehiscence. Patients with amputation readmitted to acute care are more likely to be on dialysis(p < 0.001), have a longer length of stay in acute care before admission to the rehabilitation facility(p = 0.039), and lower Section GG score on admission(p < 0.001). Age, sex, ethnicity, amputation level and history of diabetes mellitus were not associated with acute care hospital readmission. The logistic regression model revealed that patients being on dialysis was the only significant risk factor predictive of readmission to acute care (odds ration[OR] 4.82, p = 0.006).ConclusionsThis study showed that incision‐site complications were the most common cause of disruption in inpatient rehabilitation via acute hospital readmission in patients with amputation. Being on dialysis was associated with a higher risk of readmission to acute care hospitals. Based on the results of this study, specific rehabilitation plans might be required for patients with amputation that carry certain risk factors to reduce rehospitalization to the acute care unit.This article is protected by copyright. All rights reserved.

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Section: Discussioncontrasting

confidence: 88%

Risk factors for readmission of patients with amputation to acute care from inpatient rehabilitation: A retrospective cohort study

Chang

Lopez

Mei

et al. 2023

PM&R

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“… 22 , 40 , 41 A recent study confirmed an increased risk for RTAC from a freestanding IRF when compared with IRFs housed within an acute care hospital. 42 A recent narrative review further provides strong evidence that the principal predictors of RTAC are lower functional status on admission, more severe injury, and higher numbers of comorbidities. 43 This review also highlights that RTAC is a complex, multifactorial patient issue with a complex interplay between the predictors and reasons for RTAC.…”

Section: Discussionmentioning

confidence: 99%

Acute Inpatient Rehabilitation Improves Function Independent of Comorbidities in Medically Complex Patients

Zhang

Lin

Wright

et al. 2022

Archives of Rehabilitation Research and Clinical Translation

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“…21 An interruption in one's rehabilitation course may also be conducive to a loss of functional gains achieved. 22 Readmissions are particularly problematic during times of limited hospital capacity, as occurred at times during the pandemic, because they potentially detract limited resources away from other patients in need. Thus, it is important to identify patients at high risk for readmission and provide them with close medical supervision.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, transitions in care increase risk for medical errors and may provoke anxiety among patients and their families 21 . An interruption in one’s rehabilitation course may also be conducive to a loss of functional gains achieved 22 . Readmissions are particularly problematic during times of limited hospital capacity, as occurred at times during the pandemic, because they potentially detract limited resources away from other patients in need.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Patients Discharged to Skilled Nursing and Inpatient Rehabilitation Facilities Following Hospitalization for COVID-19: A Retrospective Study

Valecillos

Gober

Palermo

et al. 2022

Am J Phys Med Rehabil

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ObjectiveThe aim of the study is to identify differences in demographics, severity of disease, and rates of hospital readmission among adults discharged to skilled nursing facilities and inpatient rehabilitation facilities after hospitalization for coronavirus 2019.DesignThis is a retrospective cohort study of adults hospitalized with coronavirus 2019 infection at academic medical centers participating in the Vizient Clinical Data Base between April 1, 2020, and June 30, 2021, who were discharged to skilled nursing facilities or inpatient rehabilitation facilities (N = 39,882). Data from the Clinical Data Base are used with permission of Vizient, Inc. All rights reserved.ResultsAmong adults hospitalized with coronavirus 2019 infection, those discharged to skilled nursing facilities were 1.4 times more likely to require hospital readmission than those discharged to inpatient rehabilitation facilities. They were, on average, older (73 vs. 61 yrs, P < 0.001) and had shorter hospital lengths of stay (15 vs. 26 days, P < 0.0001) than the patients discharged to inpatient rehabilitation facilities. Persons discharged to inpatient rehabilitation facilities were more likely to have received intensive care and mechanical ventilation while hospitalized (P < 0.001).ConclusionsIndividuals discharged to inpatient rehabilitation facilities after hospitalization for coronavirus 2019 differ from those discharged to skilled nursing facilities on a number of key variables, including age, hospital length of stay, having received intensive care, and odds of hospital readmission.

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Variation in 30-Day Readmission Rates from Inpatient Rehabilitation Facilities to Acute Care Hospitals

Cited by 4 publications

References 24 publications

Risk factors for readmission of patients with amputation to acute care from inpatient rehabilitation: A retrospective cohort study

Risk factors for readmission of patients with amputation to acute care from inpatient rehabilitation: A retrospective cohort study

Acute Inpatient Rehabilitation Improves Function Independent of Comorbidities in Medically Complex Patients

A Comparison of Patients Discharged to Skilled Nursing and Inpatient Rehabilitation Facilities Following Hospitalization for COVID-19: A Retrospective Study

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