• Paul Gerrard, Richard Goldstein, Margaret A DiVita, Chloe Slocum, Colleen M Ryan, Jacqueline Mix, Paulette Niewczyk, Lewis Kazis, Ross Zafonte, and Jeffrey C Schneider.
• New England Rehabilitation Hospital of Portland, 335 Brighton Ave, Portland, ME 04102. E-mail: pbgerrard@gmail.com.
• Am J Manag Care. 2015 Apr 1; 21 (4): e282-7.

ObjectivesTo test whether functional status is a robust predictor of acute care readmission risk in patients who have been discharged to an inpatient rehabilitation facility (IRF) following a unilateral hip fracture.Study DesignRetrospective database study using a large administrative data set.MethodsA retrospective analysis of data from the Uniform Data System for Medical Rehabilitation from the years 2002 to 2011 was performed, examining patients with an impairment of unilateral hip fracture. A basic prediction model based on functional status was compared with competing models incorporating medical comorbidities. C statistics were compared to evaluate model performance.ResultsThere were a total of 433,154 patients: 32,783 (7.87%) patients were transferred back to an acute hospital, including 7937 (1.91%) transferred within 3 days, 16,150 (3.88%) transferred within 7 days, and 32,607 (7.83%) transferred within 30 days after IRF admission. The C statistics for the Basic Model are 0.710, 0.674, and 0.667 at days 3, 7, and 30, respectively. Compared with the Basic Model, the best performing Basic-Plus model was the Basic+Elixhauser Model with C statistic differences of +0.013, +0.014, and +0.019, and the best performing Age-Comorbidity Model was the Age+Elixhauser Model with C statistic differences of -0.110, -0.079, and -0.065 at days 3, 7, and 30, respectively.ConclusionsFunctional status is a robust and potentially modifiable risk factor for patients admitted to IRFs following a unilateral hip fracture.

19 keywords...

hide…