In-patient rehabilitation outcomes following lower extremity fracture in patients with pneumonia

Ijaz Ahmed, James E. Graham, Amol Karmarkar, Carl V. Granger, Kenneth Ottenbacher

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

BACKGROUND: Pneumonia is a common comorbidity among hospitalized older adults and may impede functional restoration and increase medical cost. Medicare reimbursement rates for patients receiving in-patient medical rehabilitation services are higher for individuals who have comorbid pneumonia. We examined the impact of comorbid pneumonia on outcomes for patients with lower extremity fracture receiving in-patient medical rehabilitation services. METHODS: Secondary data analysis of medical records obtained from 919 in-patient rehabilitation facilities in the United States. The sample included 153,241 subjects who received in-patient rehabilitation services following lower extremity fracture in 2005-2007. We used multivariable linear regression to evaluate the independent effects of pneumonia on stay and discharge functional status (Functional Independence Measure instrument), and logistic regression models to explore discharge to home versus not home. RESULTS: Pneumonia was a comorbidity for 4,265 (2.8%) of the subjects with lower extremity fracture. The multivariable models indicated that subjects with no paymenteligible comorbidity experienced shorter stay (regression coefficient -0.44, 95% CI -0.60 to -0.28 d), higher discharge functional status ratings (regression coefficient 1.84, 95% CI 1.42-2.25 points), and higher odds of home discharge (odds ratio 1.19, 95% CI 1.09-1.29), compared to subjects with pneumonia. CONCLUSIONS: Our findings suggest that comorbid pneumonia is associated with poorer rehabilitation outcomes (stay, discharge functional status, and discharge setting) among subjects receiving in-patient rehabilitation services for lower extremity fracture.

Original languageEnglish (US)
Pages (from-to)601-606
Number of pages6
JournalRespiratory Care
Volume58
Issue number4
DOIs
StatePublished - Apr 1 2013

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Lower Extremity
Pneumonia
Rehabilitation
Comorbidity
Logistic Models
Medicare
Medical Records
Linear Models
Odds Ratio
Costs and Cost Analysis

Keywords

  • Comorbidity
  • Disability
  • Evaluation
  • Outcomes
  • Postacute care

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

Cite this

In-patient rehabilitation outcomes following lower extremity fracture in patients with pneumonia. / Ahmed, Ijaz; Graham, James E.; Karmarkar, Amol; Granger, Carl V.; Ottenbacher, Kenneth.

In: Respiratory Care, Vol. 58, No. 4, 01.04.2013, p. 601-606.

Research output: Contribution to journalArticle

Ahmed, Ijaz ; Graham, James E. ; Karmarkar, Amol ; Granger, Carl V. ; Ottenbacher, Kenneth. / In-patient rehabilitation outcomes following lower extremity fracture in patients with pneumonia. In: Respiratory Care. 2013 ; Vol. 58, No. 4. pp. 601-606.
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