Program Interruptions and Short-Stay Transfers Represent Potential Targets for Inpatient Rehabilitation Care-Improvement Efforts

Addie Middleton, James E. Graham, Shilpa Krishnan, Kenneth Ottenbacher

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

OBJECTIVE: The objective of this work was to present comprehensive descriptive summaries of program interruptions and short-stay transfers among Medicare fee-for-service beneficiaries receiving inpatient rehabilitation after stroke, traumatic brain injury (TBI), and traumatic spinal cord injury (SCI). DESIGN: Retrospective cohort study of Medicare beneficiaries with any of the 3 conditions of interest who were admitted to inpatient rehabilitation directly from an acute hospital between July 1, 2012, and November 15, 2013. RESULTS: In the final sample (stroke, n = 71 769; TBI, n = 7109; SCI, n = 659), program interruption rates were 0.9% (stroke), 0.8% (TBI), and 1.4% (SCI). Short-stay transfer rates were 22.3% (stroke), 21.8% (TBI), and 31.6% (SCI); 14.7% of short-stay transfers and 12.3% of interruptions resulting in a return to acute care were identified as potentially preventable among those with stroke; 10.2% of transfers and 11.7% of interruptions among those with TBI, and 3.8% of transfers and 11.1% of interruptions among those with SCI. CONCLUSIONS: Broad health care policies aimed at improving quality and reducing costs are currently being implemented. Reducing program interruptions and short-stay transfers during inpatient rehabilitative care represents a potential target for care-improvement efforts. Future research focused on identifying modifiable risk factors for potentially undesirable outcomes will allow for targeted preventative interventions.

Original languageEnglish (US)
JournalAmerican Journal of Physical Medicine and Rehabilitation
DOIs
StateAccepted/In press - Sep 14 2016

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Spinal Cord Injuries
Inpatients
Rehabilitation
Stroke
Medicare
Fee-for-Service Plans
Health Policy
Cohort Studies
Retrospective Studies
Traumatic Brain Injury
Delivery of Health Care
Costs and Cost Analysis

ASJC Scopus subject areas

  • Medicine(all)
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

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title = "Program Interruptions and Short-Stay Transfers Represent Potential Targets for Inpatient Rehabilitation Care-Improvement Efforts",
abstract = "OBJECTIVE: The objective of this work was to present comprehensive descriptive summaries of program interruptions and short-stay transfers among Medicare fee-for-service beneficiaries receiving inpatient rehabilitation after stroke, traumatic brain injury (TBI), and traumatic spinal cord injury (SCI). DESIGN: Retrospective cohort study of Medicare beneficiaries with any of the 3 conditions of interest who were admitted to inpatient rehabilitation directly from an acute hospital between July 1, 2012, and November 15, 2013. RESULTS: In the final sample (stroke, n = 71 769; TBI, n = 7109; SCI, n = 659), program interruption rates were 0.9{\%} (stroke), 0.8{\%} (TBI), and 1.4{\%} (SCI). Short-stay transfer rates were 22.3{\%} (stroke), 21.8{\%} (TBI), and 31.6{\%} (SCI); 14.7{\%} of short-stay transfers and 12.3{\%} of interruptions resulting in a return to acute care were identified as potentially preventable among those with stroke; 10.2{\%} of transfers and 11.7{\%} of interruptions among those with TBI, and 3.8{\%} of transfers and 11.1{\%} of interruptions among those with SCI. CONCLUSIONS: Broad health care policies aimed at improving quality and reducing costs are currently being implemented. Reducing program interruptions and short-stay transfers during inpatient rehabilitative care represents a potential target for care-improvement efforts. Future research focused on identifying modifiable risk factors for potentially undesirable outcomes will allow for targeted preventative interventions.",
author = "Addie Middleton and Graham, {James E.} and Shilpa Krishnan and Kenneth Ottenbacher",
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N2 - OBJECTIVE: The objective of this work was to present comprehensive descriptive summaries of program interruptions and short-stay transfers among Medicare fee-for-service beneficiaries receiving inpatient rehabilitation after stroke, traumatic brain injury (TBI), and traumatic spinal cord injury (SCI). DESIGN: Retrospective cohort study of Medicare beneficiaries with any of the 3 conditions of interest who were admitted to inpatient rehabilitation directly from an acute hospital between July 1, 2012, and November 15, 2013. RESULTS: In the final sample (stroke, n = 71 769; TBI, n = 7109; SCI, n = 659), program interruption rates were 0.9% (stroke), 0.8% (TBI), and 1.4% (SCI). Short-stay transfer rates were 22.3% (stroke), 21.8% (TBI), and 31.6% (SCI); 14.7% of short-stay transfers and 12.3% of interruptions resulting in a return to acute care were identified as potentially preventable among those with stroke; 10.2% of transfers and 11.7% of interruptions among those with TBI, and 3.8% of transfers and 11.1% of interruptions among those with SCI. CONCLUSIONS: Broad health care policies aimed at improving quality and reducing costs are currently being implemented. Reducing program interruptions and short-stay transfers during inpatient rehabilitative care represents a potential target for care-improvement efforts. Future research focused on identifying modifiable risk factors for potentially undesirable outcomes will allow for targeted preventative interventions.

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