ArticlePhysical therapy2016
Examining the Association Between Comorbidity Indexes and Functional Status in Hospitalized Medicare Fee-for-Service Beneficiaries.
Article in Physical therapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Neighborhood Deprivation and Days Spent at Home After Fall-Related Hip Fracture.JAMA network open · 2025Article
- Approaches to characterising multimorbidity in older people accessing hospital care: a scoping review.European geriatric medicine · 2025Article
- Perceived Physical Activity Levels and Objective Measures: A Mixed-Methods Study of Residents Aged 65 and Above in Assisted Living Homes in Australia.Journal of aging research · 2024Article
- Can markers of disease severity improve the predictive power of claims-based multimorbidity indices?Journal of the American Geriatrics Society · 2023Article
- Development and validation of novel multimorbidity indices for older adults.Journal of the American Geriatrics Society · 2023Article
- Medicare Claim-Based National Institutes of Health Stroke Scale to Predict 30-Day Mortality and Hospital Readmission.Journal of general internal medicine · 2022Article
- Antihypertensive Deprescribing in Older Adult Veterans at End of Life Admitted to Veteran Affairs Nursing Homes.Journal of the American Medical Directors Association · 2021Article
- Article
- The Impact of Home Health Physical Therapy on Medicare Beneficiaries With a Primary Diagnosis of Dementia.Journal of the American Geriatrics Society · 2020Observational
- Using Inferred Mobility Status to Estimate the Time to Major Depressive Disorder Diagnosis Post-Spinal Cord Injury.Archives of physical medicine and rehabilitation · 2020Article
- Validation of a Claims-Based Frailty Index Against Physical Performance and Adverse Health Outcomes in the Health and Retirement Study.The journals of gerontology. Series A, Biological sciences and medical sciences · 2019Article
- The Effect of Frailty on Discharge Location for Medicare Beneficiaries After Acute Stroke.Archives of physical medicine and rehabilitation · 2019Article
- Use of Hospital-Based Rehabilitation Services and Hospital Readmission Following Ischemic Stroke in the United States.Archives of physical medicine and rehabilitation · 2019Article
- Variation in Hospital-Based Rehabilitation Services Among Patients With Ischemic Stroke in the United States.Physical therapy · 2019Article
- Article
- Current Risk Adjustment and Comorbidity Index Underperformance in Predicting Post-Acute Utilization and Hospital Readmissions After Joint Replacements: Implications for Comprehensive Care for Joint Replacement Model.Arthritis care & research · 2017Article
- Comorbidity Indices Versus Function as Potential Predictors of 30-Day Readmission in Older Patients Following Postacute Rehabilitation.The journals of gerontology. Series A, Biological sciences and medical sciences · 2017Article
- Comparing Comorbidity Indices to Predict Post-Acute Rehabilitation Outcomes in Older Adults.American journal of physical medicine & rehabilitation · 2016Article
- Dementia, Comorbidity, and Physical Function in the Program of All-Inclusive Care for the Elderly.Journal of geriatric physical therapy (2001)Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundMedicare data from acute hospitals do not contain information on functional status. This lack of information limits the ability to conduct rehabilitation-related health services research.
objectiveThe purpose of this study was to examine the associations between 5 comorbidity indexes derived from acute care claims data and functional status assessed at admission to an inpatient rehabilitation facility (IRF). Comorbidity indexes included tier comorbidity, Functional Comorbidity Index (FCI), Charlson Comorbidity Index, Elixhauser Comorbidity Index, and Hierarchical Condition Category (HCC).
designThis was a retrospective cohort study.
methodsMedicare beneficiaries with stroke, lower extremity joint replacement, and lower extremity fracture discharged to an IRF in 2011 were studied (N=105,441). Data from the beneficiary summary file, Medicare Provider Analysis and Review (MedPAR) file, and Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) file were linked. Inpatient rehabilitation facility admission functional status was used as a proxy for acute hospital discharge functional status. Separate linear regression models for each impairment group were developed to assess the relationships between the comorbidity indexes and functional status. Base models included age, sex, race/ethnicity, disability, dual eligibility, and length of stay. Subsequent models included individual comorbidity indexes. Values of variance explained (R(2)) with each comorbidity index were compared.
resultsBase models explained 7.7% of the variance in motor function ratings for stroke, 3.8% for joint replacement, and 7.3% for fracture. The R(2) increased marginally when comorbidity indexes were added to base models for stroke, joint replacement, and fracture: Charlson Comorbidity Index (0.4%, 0.5%, 0.3%), tier comorbidity (0.2%, 0.6%, 0.5%), FCI (0.4%, 1.2%, 1.6%), Elixhauser Comorbidity Index (1.2%, 1.9%, 3.5%), and HCC (2.2%, 2.1%, 2.8%). LIMITATION: Patients from 3 impairment categories were included in the sample.
conclusionsThe 5 comorbidity indexes contributed little to predicting functional status. The indexes examined were not useful as proxies for functional status in the acute settings studied.
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