The Predictive Validity of Functional Outcome Measures With Discharge Destination for Hospitalized Medical Patients

Area of Science:

• Rehabilitation Medicine
• Geriatric Medicine
• Health Services Research

Background:

• Accurate prediction of discharge destination is crucial for patient care planning and resource allocation in healthcare settings.
• Functional mobility assessment is a key component in evaluating a patient's ability to transition from hospital to home or a facility.

Purpose of the Study:

• To evaluate the predictive validity of four functional mobility outcome measures for determining discharge destination (home vs. facility).
• To compare the predictive performance of the Activity Measure for Post-Acute Care (AM-PAC) 6-Clicks, Henry Ford Mobility Level, and The Johns Hopkins Highest Level of Mobility.

Main Methods:

• A retrospective, observational study was conducted on 3999 adult patients admitted to medical units.
• Data included mobility scores from four tools (AM-PAC 6-Clicks Basic Mobility, AM-PAC 6-Clicks Daily Activity, Henry Ford Mobility Level, Johns Hopkins Highest Level of Mobility) and discharge destination.
• Predictive validity was assessed using c-statistics for early and later mobility scores.

Main Results:

• Patients discharged home (51.4%) had significantly higher mobility scores than those discharged to a facility.
• All four measures showed positive predictability for discharge home.
• The AM-PAC 6-Clicks Basic Mobility and Daily Activity measures demonstrated the highest predictive accuracy (c-statistics ranging from 0.74 to 0.80).

Conclusions:

• Functional mobility outcome measures possess good predictive validity for discharge destination.
• The AM-PAC 6-Clicks Basic Mobility score appears to be a highly reliable tool for predicting patient discharge disposition.