Rate of Return to Acute Care Hospital Based on Day and Time of Rehabilitation Admission. Issue 9 (14th June 2013) - Faulk, Clinton E.
Abstract : Objective: To determine if a patient's return to the acute care hospital (RTACH) from an inpatient rehabilitation facility (IRF) because of medical acuity is affected by the day of the week and time of rehabilitation admission. Design: Retrospective chart review. Setting: Inpatient rehabilitation facility. Participants: All adult patients admitted to the IRF from January 1, 2009, to June 30, 2011. RTACH was defined as an interruption in the patients' rehabilitation course as a result of medical and/or surgical complications requiring a higher level of care. The control group was defined as patients who completed an uninterrupted rehabilitation course. The study included 2282 patients (2026 control patients and 256 case patients). Main Outcome Measures: We compared patient demographics, admission impairment groups, discharge diagnosis, admission and discharge Functional Independent Measure (FIM) scores, length of stay, attached hospital versus outside hospital admissions, and RTACH rates between case patients and control patients. Results: Out of 2282 patients admitted to the IRF over a 30‐month period, 256 patients (10.85%) required an RTACH for a higher level of care not available in the IRF. Two statistically significant results were found for RTACH, including rehabilitation admission time and FIM scores (admission motor and cognition scores). Day of the week for inpatient rehabilitation admission was not statistically significant. Conclusion: This study found that the later in the day a patient was admitted to the IRF, the higher the rate of RTACH. In addition, a lower Motor FIM score was found to be correlated with a higher rate of RTACH. Admission day of the week was not found to be statistically significant with regard to the rate of RTACH. Further research is needed to determine the underlying contributing factors that would help decrease the rate of RTACH.