Evidence map›Paper›PMID 37733394›Full record

ArticleMedical care2023

Effects of a Rehabilitation-at-Home Program Compared to Post-acute Skilled Nursing Facility Care on Safety, Readmission, and Community Dwelling Status: A Matched Cohort Analysis.

Matthew R Augustine, Orna Intrator, Jiejin Li, Sara Lubetsky, Katherine A Ornstein, Linda V DeCherrie, Bruce Leff, Albert L Siu

Abstract read
In one paragraph

Article in Medical care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Matthew R AugustineDepartment of Medicine, Icahn School of Medicine at Mount Sinai, New York.
Orna IntratorDepartment of Public Health Sciences, University of Rochester, Rochester.
Jiejin LiDepartment of Public Health Sciences, University of Rochester, Rochester.
Sara LubetskyDepartment of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
Katherine A OrnsteinDepartment of Medicine, Icahn School of Medicine at Mount Sinai, New York.
Linda V DeCherrieDepartment of Medicine, Icahn School of Medicine at Mount Sinai, New York.
Bruce LeffDivision of Geriatrics, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD.
Albert L SiuDepartment of Medicine, Icahn School of Medicine at Mount Sinai, New York.

Funding

Residing in the Community with Dementia at the End of Life: Understanding Hospice Use and Residential SettingP30AG028741 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI ALBERT L SIU · 2010 to 2026
$21.9M
NIA NIH HHS P30 AG028741
6 · The paper itself

Abstract

objectivesTo evaluate the effectiveness and safety of Rehabilitation-at-Home (RaH), which provides high-frequency, multidisciplinary post-acute rehabilitative services in patients' homes.

designComparative effectiveness analysis. SETTING AND

participantsMedicare Fee-For-Service patients who received RaH in a Center for Medicare and Medicaid Innovation Center Demonstration during 2016-2017 (N=173) or who received Medicare Skilled Nursing Facility (SNF) care in 2016-2017 within the same geographic service area with similar inclusion and exclusion criteria (N=5535).

methodsWe propensity-matched RaH participants to a cohort of SNF patients using clinical and demographic characteristics with exact match on surgical and non-surgical hospitalizations. Outcomes included hospitalization within 30 days of post-acute admission, death within 30 days of post-acute discharge, length of stay, falls, use of antipsychotic medication, and discharge to community.

resultsThe majority of RaH participants were older than or equal to 85 years (57.8%) and non-Hispanic white (72.2%) with mean hospital length of stay of 8.1 (SD 7.6) days. In propensity-matched analyses, 10.1% (95% CI: 0.5%, 19.8) and 4.2% (95% CI: 0.1%, 8.5%) fewer RaH participants experienced hospital readmission and death, respectively. RaH participants had, on average, 2.8 fewer days (95% CI 1.4, 4.3) of post-acute care; 11.4% (95% CI: 5.2%, 17.7%) fewer RaH participants experienced fall; and 25.8% (95% CI: 17.8%, 33.9%) more were discharged to the community. Use of antipsychotic medications was no different. CONCLUSIONS AND IMPLICATIONS: RaH is a promising alternative to delivering SNF-level post-acute RaH. The program seems to be safe, readmissions are lower, and transition back to the community is improved.

Identifiers

PMID37733394
PMCPMC13035041

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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.