Abstract
Objective
To characterize the ability of the patient-reported Functional Assessment in Acute
Care Multidimensional Computerized Adaptive Test (FAMCAT) domains to predict discharge
disposition when administered during acute care stays.
Design
Cohort study. Logistic regression models were estimated to identify the ability of
FAMCAT domains to predict discharge to an institution for postacute care (PAC).
Setting
Academic medical center.
Participants
Patients admitted to general medicine services from June 2016 to June 2019 (n = 4240).
Interventions
Not applicable.
Main Outcome Measure(s)
Discharge to an institution.
Results
In this sample, 10.5% of patients were discharged to an institution for rehabilitation
versus home. FAMCAT domain scores were highly predictive of discharge to institutional
PAC. Daily Activity and Basic Mobility domains had excellent discriminative ability
for discharge to an institution (c-statistic, 0.83 and 0.87, respectively). In best
fit models accounting for additional characteristics, discrimination was outstanding
for Daily Activity (c-statistic, 0.91; 95% confidence interval, 0.89-0.94) and Basic
Mobility (c-statistic 0.92; 95% confidence interval, 0.89-0.94).
Conclusions
The FAMCAT Daily Activity and Basic Mobility domains demonstrated excellent discrimination
for identifying patients who discharged to an institutional setting for rehabilitation
and outstanding discrimination when adjusted for salient patient factors associated
with discharge disposition. Estimates obtained in this investigation are comparable
to the best discrimination achieved with clinician-rated measures to identify patients
who would require institutional PAC.
Keywords
List of abbreviations:
CI (confidence interval), EHR (electronic health record), FAMCAT (Functional Assessment in Acute Care Multidimensional Computerized Adaptive Test), PAC (postacute care), PROM (patient-reported outcomes measure), RN (registered nurse), SNF (skilled nursing facility)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 17, 2021
Accepted:
April 16,
2021
Received in revised form:
April 10,
2021
Received:
January 12,
2021
Footnotes
Presented as part of a symposium to the American Congress of Rehabilitation Medicine, November 3-8, 2019, Chicago, Illinois. This study was supported by the Eunice Kennedy Shriver National Institutes of Child Health and Human Development of the National Institutes of Health under Award Number R01HD079439, an Agency for Healthcare Research and Quality National Research Service Award T32 (Grant #5T32 HS000011-33), and a Center on Health Services Training and Research fellowship funded by the Foundation for Physical Therapy Research.
Disclosures: none.
This paper is part of a supplement from the American Congress of Rehabilitation Medicine.
Identification
Copyright
© 2021 by the American Congress of Rehabilitation Medicine.
