TY - JOUR
T1 - Association of Function, Symptoms, and Social Support Reported in Standardized Outpatient Clinic Questionnaires With Subsequent Hospital Discharge Disposition and 30-Day Readmissions
AU - Keeney, Tamra
AU - Lee, Minji K.
AU - Basford, Jeffrey R
AU - Cheville, Andrea
N1 - Funding Information:
We thank the Mayo Clinic data abstraction team, who made important contributions to this work.
Funding Information:
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).
Publisher Copyright:
© 2022 American Congress of Rehabilitation Medicine
PY - 2022/12
Y1 - 2022/12
N2 - 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.
AB - 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.
KW - Hospital readmission
KW - Patient-reported outcome measures
KW - Rehabilitation
KW - Subacute care
UR - http://www.scopus.com/inward/record.url?scp=85136727759&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85136727759&partnerID=8YFLogxK
U2 - 10.1016/j.apmr.2022.06.004
DO - 10.1016/j.apmr.2022.06.004
M3 - Article
C2 - 35803330
AN - SCOPUS:85136727759
SN - 0003-9993
VL - 103
SP - 2383
EP - 2390
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 12
ER -