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An Early and Routinely Collected Applied Cognitive Assessment Is Associated with Post-Acute Care Facility Discharge

Carla S Enriquez1, Juleen Rodakowski2, Kelly Casey3

  • 1Department of Physical Therapy Kean University.

Journal of Brown Hospital Medicine
|March 3, 2025
PubMed
Summary

Routine cognitive assessments using the Activity Measure for Post-Acute Care Applied Cognitive Inpatient Short Form (AM-PAC ACISF) can identify patients needing post-acute care (PAC). Lower scores significantly increase the likelihood of requiring PAC services after hospital discharge.

Keywords:
Activity Measure for Post-Acute Care (AM-PAC) Applied Cognitive Inpatient Short FormCognitionDischarge DispositionPost-Acute Care

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Area of Science:

  • Gerontology
  • Health Services Research
  • Cognitive Science

Background:

  • Patient cognition significantly impacts post-hospital health service needs.
  • Cognitive function is often not routinely assessed in standard hospital care.
  • Understanding cognitive status is crucial for discharge planning and resource allocation.

Purpose of the Study:

  • To investigate the association between routinely collected Activity Measure for Post-Acute Care Applied Cognitive Inpatient Short Form (AM-PAC ACISF) scores and discharge disposition.
  • To determine if applied cognition scores can predict the need for post-acute care (PAC).

Main Methods:

  • Retrospective analysis of 5,236 adult patient electronic medical records from Johns Hopkins Hospital (July 2020 - Nov 2021).
  • Evaluation of AM-PAC ACISF scores to identify patients requiring PAC.
  • Defined cognitive impairment as a raw score of 21 or less.

Main Results:

  • Patients discharged to PAC had AM-PAC ACISF t-scale scores 9.3 points lower than those discharged home.
  • The lowest tertile of AM-PAC ACISF scores indicated 3.4 times greater odds of needing PAC compared to the highest tertile (p <0.001).
  • Factors like living alone, male gender, and specific admission services (surgery, neurology, orthopedics) also increased PAC needs.

Conclusions:

  • Routinely collected cognitive assessments, like AM-PAC ACISF, can serve as a valuable care coordination strategy.
  • These assessments help identify patients at higher risk for requiring post-acute care.
  • Integrating cognitive screening into routine care can optimize discharge planning and resource utilization.