PRAGMATIC TRIAL OF TRANSITIONAL CARE WITH EARLY SUPPORTED DISCHARGE: DESIGN AND METHODOLOGY

2015 The gerontologist  
mortality. This session will demonstrate the significance of functional status as a primary endpoint for transitional care strategies for hospitalized older adults returning home after an inpatient stay. FUNCTIONAL DOMAINS AND HOSPITAL READMISSION FOLLOWING INPATIENT REHABILITATION J. Graham, University of Texas Medical Branch, Galveston, Texas Functional status is associated with risk of hospitalization/rehospitalization. However, function is not included in the acute hospital prospective
more » ... nt system or claims data. Conversely, functional status is the basis for payment in postacute inpatient rehabilitation. An 18-item function measure is collected at admission and discharge. We created dichotomous (low/high) variables from four functional domain scales: self-care, continence, mobility, and cognition. We then examined the relative utility of the different functional domains in predicting risk of 30-day unplanned rehospitalization by individually adding these four variables to our multivariable base model. Overall discrimination improved slightly: base model c-statistic = .680; c-statistic after adding functional domain variables ranged from .682 (cognition) to .715 (mobility). The odds ratios [95% CI] for the cognition, continence, self-care, and mobility domains were 1.61 [1.59,1.64], 1.86 [1.83,1.89], 2.38 [2.34,2.41], and 2.56 [2.53,2 .60], respectively. This presentation will discuss these preliminary findings in the context of current healthcare reform initiatives.
doi:10.1093/geront/gnv577.03 fatcat:jxh2xeqgwjaenhw6v6x3ttz46m