Disclosures: Erin M. Kelly, DO: No financial relationships or conflicts of interest  

Objective: To determine if hospital readmissions from acute inpatient rehabilitation are reduced if patients are co-managed with the acute care primary team during acute rehabilitation admissions. A secondary objective was to categorize the reasons for acute hospital readmission from acute rehabilitation.

Design: Retrospective chart review.

Setting: 23-bed comprehensive rehabilitation unit within an academic university based tertiary and quaternary care hospital.

Participants: 51 patients with unplanned acute hospital readmissions out of >450 patients admitted to the acute inpatient rehabilitation unit in 2018.

Interventions: A retrospective chart review was performed on patients (n=51) with unplanned acute hospital readmissions from acute rehabilitation. Analysis included: a) if consultation was placed for the acute care primary team during acute rehabilitation admission and b) if the reason for hospital readmission was secondary to an actively managed issue. We also categorized the reasons for transfer to the acute hospital.

Main Outcome Measures: Comparisons using Fisher’s exact test methodology.

Results: Fisher exact test was performed. Acute care primary teams co-managed 23 of the patients (45%). The reason for hospital readmission was secondary to an actively managed issue in 23 patients (45%). The Fisher exact test statistic value was 0.012 (P < .05). The most common reason for acute hospital readmission was infection (39.2%).

Conclusions: These data suggest that the reasons for acute hospital readmissions can be unpredictable and often involve emergent issues not previously managed. Acute care primary teams were more likely to be co-managing when an actively managed issue was the reason for readmission and less likely to be involved when the issue was new and emergent. Co-management of patients during inpatient rehabilitation admission may not prevent hospital readmissions or be the most cost-effective quality care. Determining the reason for readmission can guide the development of interventions and potential patient care models that may prevent future acute hospital readmissions from acute inpatient rehabilitation.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/an-analysis-of-medical-co-management-in-preventing-hospital-readmissions-from-acute-inpatient-rehabilitation/