The Effect of Transitional Services on 30-Day Avoidable Hospital Readmission Following Inpatient Rehabilitation...

The study aimed to evaluate the effect of the Transitional Services Clinic (TSC), a clinic dedicated to time-limited care for patients after discharge from the hospital, on 30-day potentially avoidable readmissions (PARs) following acute inpatient rehabilitation.

This retrospective cohort study and post hoc analysis was conducted at a single hospital-affiliated inpatient rehabilitation facility. The research team collected data from patients discharged between January and November 2021.

Of the 1,116 patients discharged from inpatient rehabilitation during the study time frame, 55 received transitional services through the TSC. There was no statistically significant difference in 30-day readmission rates between the TSC (7.3%) and non-TSC groups (9.0%). Patients who were referred to TSC but declined services had a readmission rate of 33.3%. The TSC was a protective factor in this subset, in that those who were eligible but declined services had a 6.16 greater odds of readmission within 30 days (95% confidence interval [CI] 1.24-34.71).

In this study, 30-day hospital readmission rates were similar between patients who received transitional services after inpatient rehabilitation and those who did not receive services. More research is needed to identify patients at high-risk of readmission that may benefit from dedicated transitional services at the time of inpatient rehabilitation discharge.