Is Profit Status of Inpatient Rehabilitation Facilities Independently Associated With 30-Day Unplanned Hospital Readmission for Medicare Beneficiaries?

Chih-ying Li, Amol Karmarkar, Yu Li Lin, Yong Fang Kuo, Kenneth Ottenbacher, James E. Graham

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: To investigate the effects of facility-level factors on 30-day unplanned risk-adjusted hospital readmission after discharge from inpatient rehabilitation facilities (IRFs). Design: Study using 100% Medicare claims data, covering 269,306 discharges from 1094 IRFs between October 2010 and September 2011. Setting: IRFs with at least 30 discharges. Participants: A total number of 1094 IRFs (N=269,306) serving Medicare fee-for-service beneficiaries. Interventions: Not applicable. Main Outcome Measures: Risk-standardized readmission rate (RSRR) for 30-day hospital readmission. Results: Profit status was the only provider-level IRF characteristic significantly associated with unplanned readmissions. For-profit IRFs had a significantly higher RSRR (13.26±0.51) than did nonprofit IRFs (13.15±0.47) (P<.001). After controlling for all other facility characteristics (except for accreditation status because of its collinearity with facility type), for-profit IRFs had a 0.1% point higher RSRR than did nonprofit IRFs, and census region was the only significant region-level characteristic, with the South showing the highest RSRR of all regions (type III test, P=.005 for both). Conclusions: Our findings support the inclusion of profit status on the IRF Compare website (a platform including IRF comparators to indicate quality of services). For-profit IRFs had a higher RSRR than did nonprofit IRFs for Medicare beneficiaries. The South had a higher RSRR than did other regions. The RSRR difference between for-profit and nonprofit IRFs could be due to the combined effects of organizational and regional factors.

Original languageEnglish (US)
JournalArchives of Physical Medicine and Rehabilitation
DOIs
StateAccepted/In press - Jan 1 2017

Fingerprint

Patient Readmission
Medicare
Inpatients
Rehabilitation
Fee-for-Service Plans
Accreditation
Censuses

Keywords

  • Long-term care
  • Nonprofit
  • Organizations
  • Patient readmission
  • Rehabilitation

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

@article{f1971c21aadb4064bdb4563546c1cfe5,
title = "Is Profit Status of Inpatient Rehabilitation Facilities Independently Associated With 30-Day Unplanned Hospital Readmission for Medicare Beneficiaries?",
abstract = "Objective: To investigate the effects of facility-level factors on 30-day unplanned risk-adjusted hospital readmission after discharge from inpatient rehabilitation facilities (IRFs). Design: Study using 100{\%} Medicare claims data, covering 269,306 discharges from 1094 IRFs between October 2010 and September 2011. Setting: IRFs with at least 30 discharges. Participants: A total number of 1094 IRFs (N=269,306) serving Medicare fee-for-service beneficiaries. Interventions: Not applicable. Main Outcome Measures: Risk-standardized readmission rate (RSRR) for 30-day hospital readmission. Results: Profit status was the only provider-level IRF characteristic significantly associated with unplanned readmissions. For-profit IRFs had a significantly higher RSRR (13.26±0.51) than did nonprofit IRFs (13.15±0.47) (P<.001). After controlling for all other facility characteristics (except for accreditation status because of its collinearity with facility type), for-profit IRFs had a 0.1{\%} point higher RSRR than did nonprofit IRFs, and census region was the only significant region-level characteristic, with the South showing the highest RSRR of all regions (type III test, P=.005 for both). Conclusions: Our findings support the inclusion of profit status on the IRF Compare website (a platform including IRF comparators to indicate quality of services). For-profit IRFs had a higher RSRR than did nonprofit IRFs for Medicare beneficiaries. The South had a higher RSRR than did other regions. The RSRR difference between for-profit and nonprofit IRFs could be due to the combined effects of organizational and regional factors.",
keywords = "Long-term care, Nonprofit, Organizations, Patient readmission, Rehabilitation",
author = "Chih-ying Li and Amol Karmarkar and Lin, {Yu Li} and Kuo, {Yong Fang} and Kenneth Ottenbacher and Graham, {James E.}",
year = "2017",
month = "1",
day = "1",
doi = "10.1016/j.apmr.2017.09.002",
language = "English (US)",
journal = "Archives of Physical Medicine and Rehabilitation",
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TY - JOUR

T1 - Is Profit Status of Inpatient Rehabilitation Facilities Independently Associated With 30-Day Unplanned Hospital Readmission for Medicare Beneficiaries?

AU - Li, Chih-ying

AU - Karmarkar, Amol

AU - Lin, Yu Li

AU - Kuo, Yong Fang

AU - Ottenbacher, Kenneth

AU - Graham, James E.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Objective: To investigate the effects of facility-level factors on 30-day unplanned risk-adjusted hospital readmission after discharge from inpatient rehabilitation facilities (IRFs). Design: Study using 100% Medicare claims data, covering 269,306 discharges from 1094 IRFs between October 2010 and September 2011. Setting: IRFs with at least 30 discharges. Participants: A total number of 1094 IRFs (N=269,306) serving Medicare fee-for-service beneficiaries. Interventions: Not applicable. Main Outcome Measures: Risk-standardized readmission rate (RSRR) for 30-day hospital readmission. Results: Profit status was the only provider-level IRF characteristic significantly associated with unplanned readmissions. For-profit IRFs had a significantly higher RSRR (13.26±0.51) than did nonprofit IRFs (13.15±0.47) (P<.001). After controlling for all other facility characteristics (except for accreditation status because of its collinearity with facility type), for-profit IRFs had a 0.1% point higher RSRR than did nonprofit IRFs, and census region was the only significant region-level characteristic, with the South showing the highest RSRR of all regions (type III test, P=.005 for both). Conclusions: Our findings support the inclusion of profit status on the IRF Compare website (a platform including IRF comparators to indicate quality of services). For-profit IRFs had a higher RSRR than did nonprofit IRFs for Medicare beneficiaries. The South had a higher RSRR than did other regions. The RSRR difference between for-profit and nonprofit IRFs could be due to the combined effects of organizational and regional factors.

AB - Objective: To investigate the effects of facility-level factors on 30-day unplanned risk-adjusted hospital readmission after discharge from inpatient rehabilitation facilities (IRFs). Design: Study using 100% Medicare claims data, covering 269,306 discharges from 1094 IRFs between October 2010 and September 2011. Setting: IRFs with at least 30 discharges. Participants: A total number of 1094 IRFs (N=269,306) serving Medicare fee-for-service beneficiaries. Interventions: Not applicable. Main Outcome Measures: Risk-standardized readmission rate (RSRR) for 30-day hospital readmission. Results: Profit status was the only provider-level IRF characteristic significantly associated with unplanned readmissions. For-profit IRFs had a significantly higher RSRR (13.26±0.51) than did nonprofit IRFs (13.15±0.47) (P<.001). After controlling for all other facility characteristics (except for accreditation status because of its collinearity with facility type), for-profit IRFs had a 0.1% point higher RSRR than did nonprofit IRFs, and census region was the only significant region-level characteristic, with the South showing the highest RSRR of all regions (type III test, P=.005 for both). Conclusions: Our findings support the inclusion of profit status on the IRF Compare website (a platform including IRF comparators to indicate quality of services). For-profit IRFs had a higher RSRR than did nonprofit IRFs for Medicare beneficiaries. The South had a higher RSRR than did other regions. The RSRR difference between for-profit and nonprofit IRFs could be due to the combined effects of organizational and regional factors.

KW - Long-term care

KW - Nonprofit

KW - Organizations

KW - Patient readmission

KW - Rehabilitation

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U2 - 10.1016/j.apmr.2017.09.002

DO - 10.1016/j.apmr.2017.09.002

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JO - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

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