Using Interpersonal Continuity of Care in Home Health Physical Therapy to Reduce Hospital Readmissions

Patrick Engel, Mark Vorensky, Allison Squires, Simon Jones
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Abstract

This paper is an examination of the relationship between continuity of care with home health physical therapists following hospitalization and the likelihood of readmission. We conducted a retrospective cohort study. Using rehospitalization as the dependent variable, a continuity of care indicator variable was analyzed with a multivariable logistic regression. The indicator variable was created using the Bice-Boxerman Index to measure physical therapist continuity of care. The mean of the index (0.81) was used to separate between high continuity (0.81 or greater) of care and low continuity of care (lower than 0.81). The sample included 90,220 patients, with data coming from the linking of the Outcome Assessment and Information Set (OASIS) and an administrative dataset. All subjects lived in the NYC metro area. Inclusion criteria was a patient’s admission to their first home health care site following discharge occurring between 2010 and 2015, and individuals who identified as Male or Female. In comparison to low continuity of physical therapy, high continuity of physical therapy significantly decreased hospital readmissions (OR = 0.74, 95% CI 0.71-0.76, p ≤ .001, AME = −4.28%). Interpersonal continuity of physical therapy care has been identified as a key factor in decreasing readmissions from the home care setting. The research suggests an increased emphasis in preserving physical therapist continuity following hospitalization should be explored, with the potential to reduce hospital readmissions.
利用家庭保健理疗中的人际持续护理减少再入院率
本文探讨了住院后接受家庭健康理疗师持续护理与再次入院可能性之间的关系。我们进行了一项回顾性队列研究。以再入院为因变量,通过多变量逻辑回归分析了护理连续性指标变量。该指标变量采用比斯-伯克曼指数(Bice-Boxerman Index)来衡量理疗师护理的连续性。该指数的平均值(0.81)被用来区分高护理连续性(0.81 或更高)和低护理连续性(低于 0.81)。样本包括 90,220 名患者,数据来自于结果评估和信息集 (OASIS) 与行政数据集的连接。所有受试者均居住在纽约大都会区。纳入标准是患者在 2010 年至 2015 年期间出院后入住其首个家庭医疗机构,且患者身份为男性或女性。与物理治疗连续性低的患者相比,物理治疗连续性高的患者再入院率明显降低(OR = 0.74,95% CI 0.71-0.76,p ≤ .001,AME = -4.28%)。理疗护理的人际连续性已被确认为降低家庭护理环境中再入院率的关键因素。研究表明,应进一步强调住院后理疗师护理的连续性,从而降低再入院率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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