Hospital Readmission Following Discharge From Inpatient Rehabilitation for Older Adults With Debility

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Health Services Research

Background:

• Debility is a common reason for inpatient rehabilitation, accounting for 10% of Medicare beneficiaries.
• Patients with debility exhibit the highest 30-day readmission rates among common inpatient rehabilitation impairment groups.

Purpose of the Study:

• To investigate the rates, timing, and contributing factors of hospital readmissions for patients with debility up to 90 days post-inpatient rehabilitation discharge.

Main Methods:

• A retrospective cohort study analyzed data from 45,424 Medicare beneficiaries with debility discharged from 1,199 facilities (2006-2009).
• Cox proportional hazard regression models were employed to assess readmission hazards, considering interactions with time for functional status, comorbidities, and chronic pulmonary disease.

Main Results:

• Readmission rates were 19% within 30 days and 34% within 90 days.
• The peak readmission day was day 3 post-discharge, with 56% occurring within 30 days.
• Improved Functional Independence Measure (FIM) motor scores at discharge were linked to reduced readmission risk before 60 days. Heart failure, renal failure, and chronic pulmonary disease were significant comorbidities associated with readmissions.

Conclusions:

• Approximately one-third of patients with debility are readmitted to acute care within 90 days of inpatient rehabilitation.
• The protective impact of enhanced motor function on readmission risk diminishes by 60 days post-discharge.