ArticlePloS one2020
A comparison of three methods in categorizing functional status to predict hospital readmission across post-acute care.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Optimizing the clinical functioning information tool (ClinFIT) in routine clinical practice: development of functional staging cutoff scores for rehabilitation provision and intensity.Journal of rehabilitation medicine · 2025Observational
- Crosswalk Algorithms for Cognitive and Functional Outcomes Among 2013-2018 Medicare Beneficiaries With Dementia.Journal of the American Medical Directors Association · 2024Article
- Data Science Trends Relevant to Nursing Practice: A Rapid Review of the 2020 Literature.Applied clinical informatics · 2022Review
- Functional Status Across Post-Acute Settings is Associated With 30-Day and 90-Day Hospital Readmissions.Journal of the American Medical Directors Association · 2021Article
- Article
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Authors and funding
8 authors.
Funding
Abstract
backgroundMethods used to categorize functional status to predict health outcomes across post-acute care settings vary significantly.
objectivesWe compared three methods that categorize functional status to predict 30-day and 90-day hospital readmission across inpatient rehabilitation facilities (IRF), skilled nursing facilities (SNF) and home health agencies (HHA). RESEARCH
designRetrospective analysis of 2013-2014 Medicare claims data (N = 740,530). Data were randomly split into two subsets using a 1:1 ratio. We used half of the cohort (development subset) to develop functional status categories for three methods, and then used the rest (testing subset) to compare outcome prediction. Three methods to generate functional categories were labeled as: Method I, percentile based on proportional distribution; Method II, percentile based on change score distribution; and Method III, functional staging categories based on Rasch person strata. We used six differentiation and classification statistics to determine the optimal method of generating functional categories.
settingIRF, SNF and HHA. SUBJECTS: We included 130,670 (17.7%) Medicare beneficiaries with stroke, 498,576 (67.3%) with lower extremity joint replacement and 111,284 (15.0%) with hip and femur fracture. MEASURES: Unplanned 30-day and 90-day hospital readmission.
resultsFor all impairment conditions, Method III best predicted 30-day and 90-day hospital readmission. However, we observed overlapping confidence intervals among some comparisons of three methods. The bootstrapping of 30-day and 90-day hospital readmission predictive models showed the area under curve for Method III was statistically significantly higher than both Method I and Method II (all paired-comparisons, p<.001), using the testing sample.
conclusionsOverall, functional staging was the optimal method to generate functional status categories to predict 30-day and 90-day hospital readmission. To facilitate clinical and scientific use, we suggest the most appropriate method to categorize functional status should be based on the strengths and weaknesses of each method.
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