Observational studyJournal of general internal medicine2020
Impact of Instrumental Activities of Daily Living Limitations on Hospital Readmission: an Observational Study Using Machine Learning.
Observational study in Journal of general internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Association of physical function with hospital readmissions among older adults: A systematic review.Journal of hospital medicine · 2025Pooled it
- Early Occupational Therapy Intervention in the Hospital Discharge after Stroke.International journal of environmental research and public health · 2021Trial
- Outcomes of 72-hour emergency department return visits requiring hospital admission in older adults: a nationally representative analysis.BMC geriatrics · 2026Article
- Interaction effect between sleep duration and dynapenic abdominal obesity for predicting functional disability: A longitudinal study.The journal of nutrition, health & aging · 2025Article
- Predicting Readmission Among High-Risk Discharged Patients Using a Machine Learning Model With Nursing Data: Retrospective Study.JMIR medical informatics · 2025Article
- Functional cognitive performance augments cognitive screening data in older adults.Frontiers in aging neuroscience · 2025Article
- Identifying Functional Status Impairment in People Living With Dementia Through Natural Language Processing of Clinical Documents: Cross-Sectional Study.Journal of medical Internet research · 2024Article
- Impact of Hospitalization on Patients Ability to Perform Basic Activities of Daily Living.Canadian geriatrics journal : CGJ · 2023Article
- Article
- A model for predicting physical function upon discharge of hospitalized older adults in Taiwan-a machine learning approach based on both electronic health records and comprehensive geriatric assessment.Frontiers in medicine · 2023Article
- Article
- Availability of information on functional limitations in structured electronic health records data.Journal of the American Geriatrics Society · 2022Article
- Dying with dignity: the challenges of end-of-life care in patients with substance use disorders.BMJ case reports · 2021Article
- Health-Related Social Needs and Increased Readmission Rates: Findings from the Nationwide Readmissions Database.Journal of general internal medicine · 2021Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundLimitations in instrumental activities of daily living (IADL) hinder a person's ability to live independently in the community and self-manage their conditions, but its impact on hospital readmission has not been firmly established.
objectiveTo test the importance of IADL dependency as a predictor of 30-day readmissions and quantify its impact relative to other morbidities.
designA retrospective cohort study of the population-based Health and Retirement Study linked to Medicare claims data. Random forest was used to rank each predictor variable in terms of its ability to predict readmission. Classification and regression tree (CART) was used to identify complex multimorbidity combinations associated with high or low risk of readmission. Generalized linear regression was used to estimate the adjusted relative risk of readmission for IADL limitations. SUBJECTS: Hospitalizations of adults age 65 and older (n = 20,007), from 6617 unique subjects. MAIN MEASURES: The main outcome was 30-day all-cause unplanned readmission. The main predictor of interest was self-reported IADL limitation. Other key predictors were self-reported complex multimorbidity including chronic diseases, geriatric syndromes, and activities of daily living (ADL) limitations, along with demographic, socioeconomic, and behavioral factors. KEY
resultsThe overall 30-day readmission rate in the study was 16.4%. Random forest analysis ranked ADLs and IADL limitations as the two most important predictors of 30-day readmission. CART identified hospitalizations of patients with IADL limitations and diabetes as a subgroup at the highest risk of readmission (26% readmitted). Multivariable regression analyses showed that ADL limitations were associated with 1.17 (1.06-1.29) times higher risk of readmission even after adjusting for other patient covariates. Risk prediction was modest though for even the best model (AUC = 0.612).
conclusionsIADL limitations are key predictors of 30-day readmission as demonstrated using several machine learning methods. Routine assessment of functional abilities in hospital settings could help identify those most at risk.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.