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 following 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 (EHR) 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
7,671 patients who were hospitalized 11,445 times between May 2004 and May 2014.
Intervention
none
Main Outcome Measures
30-day hospital readmission and discharge home versus facility.
Results
Domains were significantly associated with 30-day readmission and placement in a facility.
Specifically, mobility (OR: 1.30; 95% CI: 1.16, 1.46), ADLs (1.27; 1.13, 1.42), respiratory
symptoms (1.26; 1.12, 1.41), and psychological distress (1.20; 1.07, 1.35) had the
strongest associations with 30-day readmission. The ADL (2.52; 2.26, 2.81), mobility
(2.35; 2.10, 2.63), family support (2.28; 1.98, 2.62), and psychological distress
(1.38; 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:
CHF (congestive heart failure), COPD (chronic obstructive pulmonary disease), CAD (coronary artery disease), PNA (pneumonia), EHRs (electronic health records), CVI (Current Visit Information), MIRT (Multidimensional Item Response Theory), ADL (activities of daily living), PROM (patient-reported outcome measure), ROS (review of systems)To read this article in full you will need to make a payment
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Article Info
Publication History
Accepted:
June 2,
2022
Received in revised form:
May 23,
2022
Received:
January 31,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
