ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2017
Comorbidity Indices Versus Function as Potential Predictors of 30-Day Readmission in Older Patients Following Postacute Rehabilitation.
Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Utility of Functional Metrics Assessed During Acute Care on Hospital Outcomes: A Systematic Review.PM & R : the journal of injury, function, and rehabilitation · 2019Pooled it
- Effects of a physical activity intervention on brain atrophy in older adults at risk of dementia: a randomized controlled trial.Brain imaging and behavior · 2021Trial
- Identifying Optimal Wearable Devices for Monitoring Mobility in Hospitalized Older Adults: Feasibility, Acceptability, and Validity Study.JMIR aging · 2025Observational
- Effect of Variation in Early Rehabilitation on Hospital Readmission After Hip Fracture.Physical therapy · 2023Article
- Association of Caregiver Availability and Training With Patient Community Discharge After Stroke.Archives of rehabilitation research and clinical translation · 2023Article
- Medicare Claim-Based National Institutes of Health Stroke Scale to Predict 30-Day Mortality and Hospital Readmission.Journal of general internal medicine · 2022Article
- Identification of Functional Limitations and Discharge Destination in Patients With COVID-19.Archives of physical medicine and rehabilitation · 2021Article
- Comparing Charlson and Elixhauser comorbidity indices with different weightings to predict in-hospital mortality: an analysis of national inpatient data.BMC health services research · 2021Article
- Article
- Identifying elderly patients at risk of readmission after discharge from a short-stay unit in the emergency department using performance-based tests of daily activities.BMC geriatrics · 2020Article
- A comparison of three methods in categorizing functional status to predict hospital readmission across post-acute care.PloS one · 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
- 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
- A Retrospective Study of Administrative Data to Identify High-Need Medicare Beneficiaries at Risk of Dying and Being Hospitalized.Journal of general internal medicine · 2019Article
- 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
- Nurse Generated EHR Data Supports Post-Acute Care Referral Decision Making: Development and Validation of a Two-step Algorithm.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2017Article
- [Assessment of Three Risk Adjustment Systems as Predictors of the Consumption of Medicines and Medical Supplies at Polyvalent Hospitalization Units. Spain].Revista espanola de salud publica · 2016Article
- Activities of Daily Living of Home Healthcare Patients.Home healthcare nowArticle
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundInformation regarding the association of comorbidity indices with readmission risk for older adults receiving postacute care is limited. The purpose of this study was to compare the discriminatory ability of five comorbidity indices in predicting 30-day all-cause hospital readmission following discharge to the community from postacute inpatient rehabilitation facilities (IRF).
methodsThe sample included Medicare fee-for-service beneficiaries with stroke, lower extremity joint replacement, and fracture, discharged from IRF in 2011 (N = 75,582). Logistic regression models were used to predict 30-day all-cause readmission. Impairment-specific base models included demographic characteristics and length of stay. Subsequent models included individual comorbidity indices: Tier, Charlson, Elixhauser, functional comorbidity index (FCI), and the hierarchical condition category (HCC). We then added discharge functional status to each model. Results were compared using C-statistics.
resultsThirty-day readmission rates following discharge from an IRF ranged from 6.5% (joint replacement) to 14% (stroke). The C-statistics were 0.53, 0.56, and 0.55 for the base models in the stroke, joint replacement, and fracture groups, respectively. Adding the Tier, Charlson, FCI, or Elixhauser variables increased the C-statistics by 0.03-0.07 across the three impairment categories. Adding the HCC increased the C-statistics by 0.06-0.09. With the addition of discharge functional status in the model, the C-statistics further increased by 0.06-0.09.
conclusionsComorbidity indices were weakly associated with 30-day readmission in older adults discharged from postacute inpatient rehabilitation. Adding patient-level functional status to the comorbidity indices further improved the discriminatory ability to predict readmission in our sample.
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