Patient functional status changes during hospitalization: impact on early discharge planning

The purpose of this study was to inform the discharge planning process by determining differences in functional status from admission to discharge of adults hospitalized for either medical or surgical reasons.

The study design was a secondary analysis of data originally collected for a discharge planning study.

The primary study included 304 adult patients hospitalized at 2 hospitals in a large midwestern healthcare delivery system. Functional status data on both admission and discharge recorded in the database of participants from the primary study were used.

The Rankin Disability Scale was used to rate the participant functional status at admission and discharge in the primary study. Differences in admission to discharge Rankin Disability Scale scores overall and between groups (medical and surgical) were compared using the chi test. The absolute changes between admission and discharge score levels on the Rankin Disability Scale were computed using the Kruskal-Wallis test.

A statistically significant difference between the admission and discharge scores was found overall, although the clinical significance of the difference is questionable. No significant differences between medical and surgical participant scores (admission to discharge) were found.

For the majority of the general population of hospitalized adults, functional status may change very little, if at all, from admission to discharge.

Initiating a discharge plan based on a patient's admission functional assessment appears to be reasonable for the majority of hospitalized adult patients.