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Effects of Acute-Postacute Continuity on Community Discharge and 30-Day Rehospitalization Following Inpatient Rehabilitation
| Content Provider | Scilit |
|---|---|
| Author | Graham, James E. Bettger, Janet Prvu Middleton, Addie Spratt, Heidi Sharma, Gulshan Ottenbacher, Kenneth J. |
| Copyright Year | 2017 |
| Description | Journal: Health Services Research To examine the effects of facility-level acute-postacute continuity on probability of community discharge and 30-day rehospitalization following inpatient rehabilitation. We used national Medicare enrollment, claims, and assessment data to study 541,097 patients discharged from 1,156 inpatient rehabilitation facilities (IRFs) in 2010-2011. We calculated facility-level continuity as the percentages of an IRF's patients admitted from each contributing acute care hospital. Patients were categorized into three groups: low continuity (75 percent from same hospital). The multivariable models included an interaction term to examine the potential moderating effects of facility type (freestanding facility vs. hospital-based rehabilitation unit) on the relationships between facility-level continuity and our two outcomes: community discharge and 30-day rehospitalization. Medicare beneficiaries in hospital-based rehabilitation units were more likely to be referred from a high-contributing hospital compared to those in freestanding facilities. However, the association between higher acute-postacute continuity and desirable outcomes is significantly better in freestanding rehabilitation facilities than in hospital-based units. Improving continuity is a key premise of health care reform. We found that both observed referral patterns and continuity-related benefits differed markedly by facility type. These findings provide a starting point for health systems establishing or strengthening acute-postacute relationships to improve patient outcomes in this new era of shared accountability and public quality reporting programs. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5583304/pdf |
| Ending Page | 1646 |
| Page Count | 16 |
| Starting Page | 1631 |
| e-ISSN | 14756773 |
| DOI | 10.1111/1475-6773.12678 |
| Journal | Health Services Research |
| Issue Number | 5 |
| Volume Number | 52 |
| Language | English |
| Publisher | Wiley-Blackwell |
| Publisher Date | 2017-06-05 |
| Access Restriction | Open |
| Subject Keyword | Journal: Health Services Research Public Health and Health Services Referrals and Referral Networks Quality of Care/patient Safety (measurement) Rehabilitation Services |
| Content Type | Text |
