The affiliation of discharge vacation spot with 30-day rehospitalization charges amongst older adults receiving lumbar spinal fusion surgical procedure.
Musculoskelet Sci Pract. 2018 Jan 12;34:77-82
Authors: Cook dinner C, Coronado RA, Bettger JP, Graham JE
BACKGROUND: As outlined by Medicare (United States), post-acute rehabilitation companies embody care supplied in inpatient rehabilitation items and services, expert nursing services, long-term acute hospitals, and by house well being companies.
METHODS: We retrospectively evaluated using rehabilitation-based post-acute companies amongst Medicare beneficiaries who had been hospitalized for lumbar spinal fusion (ICD-9-CM process codes 81.04-81.08) in 2012-2014, examined the case-mix for these discharged to rehabilitation- and non-rehabilitation primarily based companies, and decided the affiliation between these classes of discharge disposition and 30-day rehospitalization. The impartial impact of rehabilitation-based discharge vacation spot on 30-day readmissions was examined with a generalized linear blended mannequin, first adjusting for affected person traits after which stratified by clusters that delineated extra homogenous medical profiles.
RESULTS: Amongst 261,558 Medicare beneficiaries with lumbar spinal fusion surgical procedure, 50.eight% had been discharged to a rehabilitation-based post-acute companies. Sufferers discharged to rehabilitation-based companies had been older and had extra comorbidities, and had longer hospital lengths of stays. After adjusting for affected person and hospital traits, sufferers discharged to rehabilitation-based post-acute care had elevated odds of 30-day rehospitalization than these with out discharge to different locations (OR 1.36; 95%CI?=?1.31, 1.40). Evaluation of sufferers by medical profile clusters discovered comparable outcomes.
CONCLUSIONS: Medical profiles of Medicare beneficiaries who had lumbar spinal fusion surgical procedure and had been discharged to rehabilitation-based post-acute companies included extra comorbidities than these discharged to non-rehabilitation primarily based settings. Controlling for these variations didn’t mediate the unfavourable affiliation between use of rehabilitation-based post-acute companies and 30-day readmission.
PMID: 29358104 [PubMed – as supplied by publisher]