Abstract
Objective
To determine whether patient-reported information, routinely collected in an outpatient
setting, is associated with readmission within 30 days of discharge and/or the need
for post-acute care after a subsequent hospital admission.
Design
Retrospective cohort study. Six domains of patient-reported information collected
in the outpatient setting (psychological distress, respiratory symptoms, musculoskeletal
pain, family support, mobility, and activities of daily living [ADLs]) were linked
to electronic health record hospitalization data. Mixed effects logistic regression
models with random intercepts were used to identify the association between the 6
domains and outcomes.
Setting
Outpatient clinics and hospitals in a Midwestern health system.
Participants
7671 patients who were hospitalized 11,445 times between May 2004 and May 2014 (N=7671).
Intervention
None.
Main Outcome Measures
30-day hospital readmission and discharge home vs facility.
Results
Domains were significantly associated with 30-day readmission and placement in a facility.
Specifically, mobility (odds ratio [OR]=1.30; 95% confidence interval [CI], 1.16,
1.46), ADLs (OR=1.27; 95% CI, 1.13, 1.42), respiratory symptoms (OR=1.26; 95% CI,
1.12, 1.41), and psychological distress (OR=1.20; 95% CI, 1.07, 1.35) had the strongest
associations with 30-day readmission. The ADL (OR=2.52; 95% CI, 2.26, 2.81), mobility
(OR=2.35; 95% CI, 2.10, 2.63), family support (OR=2.28; 95% CI, 1.98, 2.62), and psychological
distress (OR=1.38; 95% CI, 1.25, 1.52) domains had the strongest associations with
discharge to an institution.
Conclusions
Patient-reported function, symptoms, and social support routinely collected in outpatient
clinics are associated with future 30-day readmission and discharge to an institutional
setting. Whether these data can be leveraged to guide interventions to address patient
needs and improve outcomes requires further research.
Keywords
List of abbreviations:
ADLs (activities of daily living), CI (confidence interval), CVI (current visit information), EHR (electronic health record), MIRT (multidimensional item response theory), OR (odds ratio), PROM (patient-reported outcome measure), ROS (review of systems), 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: July 05, 2022
Accepted:
June 2,
2022
Received in revised form:
May 23,
2022
Received:
January 31,
2022
Footnotes
This work was supported in part by the Mayo Clinic Kern Center for the Science of Healthcare Delivery (MKL, AC), an Agency for Healthcare Research and Quality National Research Service Award T32 (Grant #5T32 HS000011-33; TK), and a Center on Health Services Training and Research fellowship funded by the Foundation for Physical Therapy Research (TK).
Disclosures: none.
Identification
Copyright
© 2022 by the American Congress of Rehabilitation Medicine.
