Abstract
Objective
Design
Participants
Main Outcome Measure
Results
Conclusions
Keywords
List of abbreviations:
ADRD (Alzheimer disease and related dementias), CMS (Centers for Medicare and Medicaid Services), ICD-9 (International Classification of Diseases, 9th Revision), OASIS (Outcome and Assessment Information Set), OR (odds ratio), PPR (potentially preventable readmissions)Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationReferences
The Medicare Payment Advisory Commission. A databook: healthcare spending and the Medicare program. 2019. Available at: http://www.medpac.gov/docs/default-source/data-book/jun19_databook_entirereport_sec.pdf?sfvrsn=0. Accessed November 12, 2019.
- Patient preferences for stroke rehabilitation.Top Stroke Rehabil. 2010; 17: 394-400
- Why older adults may decline offers of post-acute care services: a qualitative descriptive study.Geriatr Nurs. 2017; 38: 238-243
- Home health providers.(Available at:)https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/HHAs.htmlDate accessed: February 16, 2018
- Long-term care providers and services users in the United States: data from the National Study of Long-Term Care Providers, 2013-2014.Vital Health Stat. 2016; 3: 1-105
- Implicit memory and familiarity among elders with dementia.J Nurs Scholarsh. 2002; 34: 263-267
- Rise of post-acute care facilities as a discharge destination of US hospitalizations.JAMA Intern Med. 2015; 175: 295-296
- Home health care expenditures in the United States from 1960 to 2016.In: US Department of Health and Human Services., 2018 (Available at:) (Accessed August 14, 2019)
- Home health compare.(Available at:)http://www.medicare.gov/HHCompare/Home.aspDate accessed: June 10, 2019
Acumen, LLC. Home health claims-based rehospitalization measures technical report. 2017. Available at: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/Home-Health-Quality-Measures. Accessed June 10, 2019.
- Functional status outperforms comorbidities in predicting acute care readmissions in medically complex patients.J Gen Intern Med. 2015; 30: 1688-1695
- The prevalence, reasons, and risk factors for hospital readmissions among home health care patients: a systematic review.Home Health Care Manag Pract. 2018; 30: 83-92
- Factors associated with accelerated hospitalization and re-hospitalization among Medicare home health patients.J Gerontol A Biol Sci Med Sci. 2018; 73: 1280-1286
- Hospitalization risk factors of older cohorts of home health care patients: a systematic review.Home Health Care Serv Q. 2019; 38: 111-152
- Motor and cognitive functional status are associated with 30-day unplanned rehospitalization following post-acute care in Medicare fee-for-service beneficiaries.J Gen Intern Med. 2016; 31: 1427-1434
- IMPACT Act of 2014 data standardization and cross setting measures.(Available at:)
- Risk factors for repeated hospitalizations among home healthcare recipients.J Healthc Qual. 2003; 25: 1-11
- Utilizing home healthcare electronic health records for telehomecare patients with heart failure: a decision tree approach to detect associations with rehospitalizations.Comput Inform Nurs. 2016; 34: 175-182
- A model for hospital discharge preparation: from case management to care transition.J Nurs Adm. 2015; 45: 606-614
- Transitions in care for older adults with and without dementia.J Am Geriatr Soc. 2012; 60: 813-820
- Medicare utilization and expenditures before and after the diagnosis of dementia.Alzheimers Dement. 2015; 11: 180
- Hospitalizations for ambulatory care sensitive conditions and unplanned readmissions among Medicare beneficiaries with Alzheimer's disease.Alzheimers Dement. 2017; 13: 1174-1178
- Potentially avoidable hospitalizations among Medicare beneficiaries with Alzheimer's disease and related disorders.Alzheimers Dement. 2013; 9: 30-38
- Association of dementia with early rehospitalization among Medicare beneficiaries.Arch Gerontol Geriatr. 2014; 59: 162-168
- Dementia and hospital readmission rates: a systematic review.Dement Geriatr Cogn Dis Extra. 2017; 7: 346-353
- Outcome and Assessment Information Set (OASIS): a review of validity and reliability.Home Health Care Serv Q. 2012; 31: 267-301
- Measure specifications for measures in the CY 2017 HH QRP final rule.(Available at:)
- The accuracy of medicare claims data in identifying Alzheimer's disease.J Clin Epidemiol. 2002; 55: 929-937
- Impact of dementia on payments for long-term and acute care in an elderly cohort.Med Care. 2013; 51: 575-581
- 2015 Alzheimer's disease facts and figures.Alzheimers Dement. 2015; 11: 332-384
- Monetary costs of dementia in the United States.N Engl J Med. 2013; 368: 1326-1334
- Functional status is associated with 30-day potentially preventable hospital readmissions after inpatient rehabilitation among aged Medicare fee-for-service beneficiaries.Arch Phys Med Rehabil. 2018; 99: 1067-1076
- Functional status is associated with 30-day potentially preventable readmissions following home health care.Med Care. 2019; 57: 145-151
- Functional status is associated with 30-day potentially preventable readmissions following skilled nursing facility discharge among Medicare beneficiaries.J Am Med Dir Assoc. 2018; 19: 348-354
- Potentially preventable within-stay readmissions among Medicare fee-for-service beneficiaries receiving inpatient rehabilitation.PM R. 2017; 9: 1095-1105
- 2019 Alzheimer's disease facts and figures.Alzheimers Dement. 2019; 15: 321-387
- The GDS/FAST staging system.Int Psychogeriatr. 1997; 9: 167
- Effectiveness of caregiver interventions on patient outcomes in adults with dementia or Alzheimer's disease: a systematic review.Gerontol Geriatr Med. 2015; 1 (2333721415595789)
- Readmissions reduction program.(Availabe at:)http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Readmissions-Reduction-Program.htmlDate accessed: January 16, 2016
- Effectiveness of remote patient monitoring after discharge of hospitalized patients with heart failure: the Better Effectiveness After Transition -- Heart Failure (BEAT-HF) randomized clinical trial.JAMA Int Med. 2016; 176: 310-318
- Impact of a multidisciplinary heart failure post-hospitalization program on heart failure readmission rates.Ann Pharmacother. 2015; 49: 1189-1196
- Transitional care interventions to prevent readmissions for persons with heart failure: a systematic review and meta-analysis.Ann Intern Med. 2014; 160: 774-784
- Diagnosis and management of urinary tract infection in older adults.Infect Dis Clin North Am. 2014; 28: 75-89
- Cause of death in patients with dementia disorders.Eur J Neurol. 2009; 16: 488-492
- Hospitalization in community-dwelling persons with Alzheimer’s disease: frequency and causes.J Am Geriatr Soc. 2010; 58: 1542-1548
- The clinical course of advanced dementia.N Engl J Med. 2009; 361: 1529-1538
- Identifying dementia cases with routinely collected health data: a systematic review.Alzheimers Dement. 2018; 14: 1038-1051
Article Info
Publication History
Footnotes
Supported by the National Institutes of Health (grant nos. R01HD069443 , P2CHD065702 , K01AG058789 , U54GM104941 ), National Institute of Aging (grant no. K01AG058789), and the Foundation for Physical Therapy’s Center of Excellence in Physical Therapy Health Services and Health Policy Research and Training Grant.