Home-Based Occupational Therapy and Stroke Readmissions in Medicaid Recipients

Area of Science:

• Neurology
• Rehabilitation Medicine
• Health Services Research

Background:

• Stroke is a leading cause of long-term disability and readmissions.
• Hospital readmissions post-stroke are costly and impact patient outcomes.
• Medicaid recipients represent a vulnerable population with specific healthcare needs.

Purpose of the Study:

• To investigate the effectiveness of home-based occupational therapy in reducing 30- and 90-day hospital readmissions after ischemic stroke.
• To analyze readmission rates among adult Medicaid recipients in Tennessee.
• To identify factors associated with hospital readmissions post-stroke.

Main Methods:

• Retrospective cohort study using Tennessee Medicaid data (2016-2023).
• Inclusion criteria: adults (18+) with ischemic stroke discharged from hospital.
• Logistic regression models were used to assess the association between home-based occupational therapy and readmissions, controlling for covariates.

Main Results:

• 19.6% of 3,393 patients were readmitted within 30 days; 27.3% within 90 days.
• Unadjusted analysis indicated home-based occupational therapy was associated with lower 30-day readmissions (OR: 0.57; 95% CI: [0.36, 0.90]).
• Patients from suburban/rural areas had higher 30-day readmission likelihood (AOR: 1.28; 95% CI: [1.02, 1.60]).

Conclusions:

• Home-based occupational therapy shows promise in reducing post-stroke hospital readmissions for Medicaid beneficiaries.
• Geographic location (suburban/rural) is a factor associated with increased readmission risk.
• Further research with adjusted analyses is warranted to confirm the impact of occupational therapy.