Session Information
Date: Saturday, November 16, 2019
Session Title: Annual Assembly Late Breaking Posters (Non Presentations)
Session Time: 11:15am-12:45pm
Location: Research Hub - Kiosk 8
Disclosures: Kenton L. Hagan, MD, MBA, MSF: No financial relationships or conflicts of interest
Objective: Finding tools which can help predict patient outcomes is of utmost importance in the new age of value-based medicine. Our study examines whether objective measures of function, medical stability, and demographics can help predict which patients are most likely to be discharged home from an inpatient rehabilitation facility and the length of stay during their inpatient rehabilitation stay.
Design: Retrospective Chart Review
Setting: Academic freestanding inpatient rehabilitation center
Participants: Admissions from 3/1/17-2/28/18.
Interventions: None
Main Outcome Measures: Length of stay and discharge location.
Results: Binary logistic regression was utilized to model the likelihood of home discharge and found that AMPAC and LACE+ scores were significant while age, gender, race, and diagnosis were insignificant estimators. The odds ratio for LACE+ was 0.97 (95% CI 0.96, 0.98) and for AMPAC was 1.17 (1.14, 1.21). Subgroup analysis was performed and found that mid-AMPAC (scores 25-36) sub-group had a odds ratio of 6.33 of discharge to home compared to the low AMPAC (scores 12-24) group. Similar analysis performed with LACE+ indicating that both low (LACE+ 1-33) and mid (LACE+ 34-66) groups had significantly higher odds ratios of discharge to home, 4.34 (2.34, 7.75) and 1.83 (1.21, 2.78), compared to the high LACE+ (67 and higher) group. Similar to discharge outcomes, it was found that AMPAC and LACE+ scores were significant predictors of inpatient rehabilitation length of stay. Furthermore, low and mid-AMPAC score groups had significantly increasing length of stay if the patient was in the mid or high-LACE+ group while LACE+ had no impact on the high AMPAC sub-group.
Conclusions: Improved predictive tools may allow for improved resource allocation recommendations by the consulting physiatrist for patients in the acute care setting as we demonstrated that increasing a patient’s functional measures in acute care can significantly alter their likelihood of a home discharge from and length of stay at an inpatient rehabilitation facility.
Level of Evidence: Level III
To cite this abstract in AMA style:
Hagan KL, Charles J. Predictive Ability of Acute Care Functional and Medical Stability Measures on Likelihood of Home Discharge and Length of Stay from Inpatient Rehabilitation Facilities [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/predictive-ability-of-acute-care-functional-and-medical-stability-measures-on-likelihood-of-home-discharge-and-length-of-stay-from-inpatient-rehabilitation-facilities/. Accessed December 11, 2024.« Back to AAPM&R Annual Assembly 2019
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/predictive-ability-of-acute-care-functional-and-medical-stability-measures-on-likelihood-of-home-discharge-and-length-of-stay-from-inpatient-rehabilitation-facilities/