Hospital readmissions in brain dysfunction or neurological conditions after inpatient medical rehabilitation
Tuesday, November 5, 2013
Identify 30-day hospital readmission rates in Medicare beneficiaries with brain dysfunction and neurological conditions who required intensive inpatient medical rehabilitation following hospital discharge. Secondary analysis of Medicare fee-for-service data using Inpatient Rehabilitation Facilities Patient Assessment Instrument (IRF-PAI) and Medicare Provider Analysis and Review (MEDPAR) data files. We selected patients with brain dysfunction (n=37,890; traumatic, non-traumatic brain injury) or neurological conditions (n=42,600; Parkinson's, neuromuscular disorders, etc.) who were admitted to inpatient rehabilitation facilities from acute hospitals in 2006-2009, were completing their initial rehabilitation stay, living in the community prior to acute hospitalization, age 66 or older, and who did not experience a program interruption during their rehabilitation stay. Hospital readmission (yes/no) was determined for those patients who were discharged to community settings after rehabilitation stay. The observation period extended to 30 days after discharge from the acute hospital stay. The 30-day readmission rates were approximately 11% (n=4,333) and 12% (n=5,223) for brain dysfunction and neurological conditions, respectively. For both impairment groups, the proportions of comorbidities were greater and more severe in the readmission group compared to those without readmission. Rehabilitation length of stay and functional status at the time of discharge were lower in the readmission group as compared to those without readmission. Rehospitalization rates are not only established quality indicators, but they can also directly affect Medicare reimbursements. Thus, it is increasingly important to identify high-risk patients, improve care transitions, and increase continuity across contiguous venues representing an entire episode of care.
Public health or related research
Identify 30-day hospital readmission rates in Medicare beneficiaries with brain dysfunction and neurological conditions who required intensive inpatient medical rehabilitation following hospital discharge.
Keyword(s): Medicare, Outcomes Research
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I am one of the co-investigators on the federally funded grant, whose purpose is to examine risk factors associated with hospital readmission in patients after their rehabilitation stay. I have been working with administrative claims data for over three years. I believe my clinical training and research experience related to managing and analyzing large datasets provide me with the knowledge and skills necessary to conduct learning objectives that were listed in the abstract.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.