Functional status impairment is associated with unplanned readmissions

Area of Science:

• Rehabilitation Medicine
• Health Services Research
• Patient Outcomes

Background:

• Unplanned readmissions to acute care pose a significant burden on healthcare systems.
• Identifying predictors of readmission is crucial for developing targeted interventions.
• Functional status is a key component of recovery following inpatient rehabilitation.

Purpose of the Study:

• To investigate the association between functional status at admission to a Comprehensive Integrated Inpatient Rehabilitation Program (CIIRP) and subsequent unplanned acute care readmissions.
• To determine if specific domains of functional status (motor vs. cognitive) have differential impacts on readmission risk.

Main Methods:

• Retrospective cohort study of 1515 patients admitted to an academic hospital-based CIIRP.
• Functional status assessed using tertiles of the total Functional Independence Measure (FIM) score at admission.
• Propensity score adjustment for 25 clinical and demographic variables to control for confounding.

Main Results:

• A total of 347 readmissions (23%) were observed among 1515 patients.
• Lower FIM scores were significantly associated with increased odds of total readmissions (OR=2.6 for lowest tertile, OR=1.7 for middle tertile).
• Motor function domain scores showed a stronger association with readmissions than cognitive domain scores.

Conclusions:

• Patient functional status at CIIRP admission is a strong predictor of acute care readmission.
• Readmission risk is particularly elevated for patients with lower motor function and for those readmitted before planned discharge.
• Functional status represents a potentially modifiable target for strategies aimed at reducing hospital readmissions.