Is referral to home health rehabilitation after inpatient rehabilitation facility associated with 90-day hospital readmission for adult patients with stroke?

Ickpyo Hong, Sara Knox, Loree Pryor, Tracy M. Mroz, James E. Graham, Meredith F. Shields, Timothy A. Reistetter

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective We examined the association between home health rehabilitation referral and 90-day risk-adjusted hospital readmission after discharge from inpatient rehabilitation facilities among adult patients recovering from stroke (N = 1219). Design A secondary data analysis of the 2005-2006 Stroke Recovery in Underserved Population database. A logistic regression model, multilevel model, and the propensity score inverse probability weighting model were used to evaluate the risk of 90-day rehospitalization between patients with stroke who received a referral for home health rehabilitation and those who did not receive a home health rehabilitation referral at inpatient rehabilitation facility discharge. Results The regression, multilevel, and propensity score inverse probability weighting models indicated that inpatient rehabilitation facility patients with stroke who received home health rehabilitation referral had substantially lower odds of 90-day rehospitalization after inpatient rehabilitation facility discharge compared with those who were not referred to home health (odds ratio = 0.325, 95% confidence interval = 0.138-0.764; odds ratio = 0.340, 95% confidence interval = 0.139-0.832; odds ratio = 0.407, 95% confidence interval = 0.183-0.906, respectively). Conclusions Our findings suggest the importance of continuation of care (home health) after hospitalization and intense inpatient rehabilitation for stroke. Additional research is needed to establish appropriate use criteria and explore potential underuse of home health services as well as the benefits for follow-up outpatient services for those who do not qualify for home health at inpatient rehabilitation facility discharge.

Original languageEnglish (US)
Pages (from-to)837-841
Number of pages5
JournalAmerican Journal of Physical Medicine and Rehabilitation
Volume99
Issue number9
DOIs
StatePublished - Sep 1 2020

Keywords

  • Comparative Effectiveness Research
  • Home Health Agencies
  • Hospital Readmission
  • Stroke

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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