ArticleJournal of general internal medicine2015
Functional Status Outperforms Comorbidities in Predicting Acute Care Readmissions in Medically Complex Patients.
Article in Journal of general internal medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.
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Who cites it
44 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review of prediction models for postacute care destination decision-making.Journal of the American Medical Informatics Association : JAMIA · 2021Pooled it
- Development of a predictive model of hospitalization in primary care patients with heart failure.PloS one · 2019Trial
- The Geriatric Emergency Department Intervention model of care: a pragmatic trial.BMC geriatrics · 2018Trial
- Approaches to characterising multimorbidity in older people accessing hospital care: a scoping review.European geriatric medicine · 2025Article
- Comparison of two modeling approaches for the identification of predictors of complications in children with cerebral palsy following spine surgery.BMC medical research methodology · 2024Article
- Disparities in transitions of acute stroke care: The transitions of care stroke disparities study methodological report.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2023Observational
- Functional status in rural and urban adults: The Canadian Longitudinal Study on Aging.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2022Article
- Acute Inpatient Rehabilitation Improves Function Independent of Comorbidities in Medically Complex Patients.Archives of rehabilitation research and clinical translation · 2022Article
- Article
- Clinical impact of functional independent measure (FIM) on 180-day readmission and mortality in elderly patients hospitalized with acute decompensated heart failure.Heart and vessels · 2021Article
- Man vs. Machine: Comparing Physician vs. Electronic Health Record-Based Model Predictions for 30-Day Hospital Readmissions.Journal of general internal medicine · 2021Article
- Identification of Functional Limitations and Discharge Destination in Patients With COVID-19.Archives of physical medicine and rehabilitation · 2021Article
- BOOSTing patient mobility and function on a general medical unit by enhancing interprofessional care.Scientific reports · 2021Article
- Risk of Hospital Readmission among Older Patients Discharged from the Rehabilitation Unit in a Rural Community Hospital: A Retrospective Cohort Study.Journal of clinical medicine · 2021Article
- Function and Caregiver Support Associated With Readmissions During Home Health for Individuals With Dementia.Archives of physical medicine and rehabilitation · 2020Article
- Sepsis Survivors Transitioned to Home Health Care: Characteristics and Early Readmission Risk Factors.Journal of the American Medical Directors Association · 2020Article
- In Pursuit of Meaningful Performance Measures for Postacute Care.JAMA network open · 2019Article
- Can we understand population healthcare needs using electronic medical records?Singapore medical journal · 2019Article
- Association of Functional Impairment in Middle Age With Hospitalization, Nursing Home Admission, and Death.JAMA internal medicine · 2019Article
- Risk of 30-Day Hospital Readmission Among Patients Discharged to Skilled Nursing Facilities: Development and Validation of a Risk-Prediction Model.Journal of the American Medical Directors Association · 2019Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine functional status versus medical comorbidities as predictors of acute care readmissions in medically complex patients.
designRetrospective database study.
settingU.S. inpatient rehabilitation facilities.
participantsSubjects included 120,957 patients in the Uniform Data System for Medical Rehabilitation admitted to inpatient rehabilitation facilities under the medically complex impairment group code between 2002 and 2011.
interventionsA Basic Model based on gender and functional status was developed using logistic regression to predict the odds of 3-, 7-, and 30-day readmission from inpatient rehabilitation facilities to acute care hospitals. Functional status was measured by the FIM(®) motor score. The Basic Model was compared to six other predictive models-three Basic Plus Models that added a comorbidity measure to the Basic Model and three Gender-Comorbidity Models that included only gender and a comorbidity measure. The three comorbidity measures used were the Elixhauser index, Deyo-Charlson index, and Medicare comorbidity tier system. The c-statistic was the primary measure of model performance.
main outcome measuresWe investigated 3-, 7-, and 30-day readmission to acute care hospitals from inpatient rehabilitation facilities.
resultsBasic Model c-statistics predicting 3-, 7-, and 30-day readmissions were 0.69, 0.64, and 0.65, respectively. The best-performing Basic Plus Model (Basic+Elixhauser) c-statistics were only 0.02 better than the Basic Model, and the best-performing Gender-Comorbidity Model (Gender+Elixhauser) c-statistics were more than 0.07 worse than the Basic Model.
conclusionsReadmission models based on functional status consistently outperform models based on medical comorbidities. There is opportunity to improve current national readmission risk models to more accurately predict readmissions by incorporating functional data.
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