Dataset Information

The Unmet Need for Postacute Rehabilitation Among Medicare Observation Patients: A Single-Center Study.

ABSTRACT:

Background

Medicare beneficiaries admitted under observation status must pay for postacute inpatient rehabilitation (PAIR) services, out of pocket, at potentially prohibitive costs.

Objective

To determine if there is an unmet need for PAIR among Medicare observation patients and if this care is associated with longer hospital stay and increased rehospitalization.

Design/setting

Observational study using electronic medical record and administrative data from a regional health system.

Patients

1323 community-dwelling Medicare patients admitted under observation status.

Measurements

Summary statistics were calculated for demographic and administrative variables. Physical therapy (PT) and case management recommendations for a representative sample of 386 medical records were reviewed regarding need for PAIR services. Linear regression was used to measure the association between PT recommendation and hospital length of stay, adjusting for ICD-9 (International Classification of Diseases, Ninth Revision) diagnosis, age, sex, and provider. Chi-square test was used to determine the association between PT recommendation and 30-day hospital revisit.

Results

Of the 1323 study patients, 11 (0.83%) were discharged to PAIR facilities. However, 17 (4.4%) of the 386 patients whose charts were reviewed received a recommendation for this care. Adjusted mean hospital stay was longer (P ⟨ 0.001) for patients recommended for rehabilitation (75.9 h) than for patients with no PT needs (46.8 h). In addition, the 30-day hospital revisit rate was higher (P = 0.037) for the patients who had been recommended for rehabilitation (52.9%, 9/17) than for those who had not (25.4%, 30/118).

Conclusions

Medicare observation patients' potential need for PAIR services is 5- to 6-fold higher than their use of these services. Observation patients recommended for this care may have worse outcomes. Journal of Hospital Medicine 2017;12:168-172.

SUBMITTER: Goldstein JN

PROVIDER: S-EPMC6467081 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The Unmet Need for Postacute Rehabilitation Among Medicare Observation Patients: A Single-Center Study.

Goldstein Jennifer N JN Schwartz J Sanford JS McGraw Patricia P Banks Tobias L TL Hicks LeRoi S LS

Journal of hospital medicine 20170301 3

<h4>Background</h4>Medicare beneficiaries admitted under observation status must pay for postacute inpatient rehabilitation (PAIR) services, out of pocket, at potentially prohibitive costs.<h4>Objective</h4>To determine if there is an unmet need for PAIR among Medicare observation patients and if this care is associated with longer hospital stay and increased rehospitalization.<h4>Design/setting</h4>Observational study using electronic medical record and administrative data from a regional healt ...[more]

PMID: 28272593

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Dataset Information

The Unmet Need for Postacute Rehabilitation Among Medicare Observation Patients: A Single-Center Study.

Background

Objective

Design/setting

Patients

Measurements

Results

Conclusions

Publications

The Unmet Need for Postacute Rehabilitation Among Medicare Observation Patients: A Single-Center Study.

Similar Datasets

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