Analysis of the impact of High Acuity Rehabilitation beds in reducing readmission rate to acute care.

IF 2.4 4区医学 Q1 REHABILITATION

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-05-23 DOI:10.1097/PHM.0000000000002780

Francesco Sammartino, Eunkyung Yu, Tracy Huffman, Angela Harris, Maureen Musto, Sarah Schultz, McKenzie Callicoat, Sheital Bavishi

{"title":"Analysis of the impact of High Acuity Rehabilitation beds in reducing readmission rate to acute care.","authors":"Francesco Sammartino, Eunkyung Yu, Tracy Huffman, Angela Harris, Maureen Musto, Sarah Schultz, McKenzie Callicoat, Sheital Bavishi","doi":"10.1097/PHM.0000000000002780","DOIUrl":null,"url":null,"abstract":"Objective: The aim of this study is to describe the use of the high acuity rehabilitation program (HARP) at an academic rehabilitation institution to limit the readmission rate to acute care hospitals.Design: Retrospective data from inpatient admissions and discharges between January 2019 to June 2023 was used for this study. Modeling was performed using stepwise regression to select intrinsic and extrinsic patient factors associated with acute admission status. The model performance was assessed using confusion matrices and ROC curves.Results: Among the 199 patients who utilized the HARP unit from January 2019 to June 2023, 96 were discharged acutely to a hospital, while 103 were discharged to home, SNF, or LTAC. The most frequent impairment groups among HARP users were brain injury (22%), debility (21%), and spinal cord injury (18%). The improvement in GG scores for self-care and mobility was associated with successful discharges to non-acute care settings.Conclusions: Unplanned discharges from rehabilitation to acute care (RTAC) are a reason for prolonged hospital stays and increased financial burden on patients. The implementation of a High Acuity Rehabilitation Program (HARP) can help in the management of temporary medical conditions.","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Physical Medicine & Rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/PHM.0000000000002780","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: The aim of this study is to describe the use of the high acuity rehabilitation program (HARP) at an academic rehabilitation institution to limit the readmission rate to acute care hospitals.

Design: Retrospective data from inpatient admissions and discharges between January 2019 to June 2023 was used for this study. Modeling was performed using stepwise regression to select intrinsic and extrinsic patient factors associated with acute admission status. The model performance was assessed using confusion matrices and ROC curves.

Results: Among the 199 patients who utilized the HARP unit from January 2019 to June 2023, 96 were discharged acutely to a hospital, while 103 were discharged to home, SNF, or LTAC. The most frequent impairment groups among HARP users were brain injury (22%), debility (21%), and spinal cord injury (18%). The improvement in GG scores for self-care and mobility was associated with successful discharges to non-acute care settings.

Conclusions: Unplanned discharges from rehabilitation to acute care (RTAC) are a reason for prolonged hospital stays and increased financial burden on patients. The implementation of a High Acuity Rehabilitation Program (HARP) can help in the management of temporary medical conditions.

查看原文本刊更多论文

高锐度康复床位对降低急诊再入院率的影响分析。

目的：本研究的目的是描述在学术康复机构使用高锐康复计划（HARP）来限制再入院率到急症护理医院。设计：本研究使用2019年1月至2023年6月住院和出院患者的回顾性数据。采用逐步回归进行建模，选择与急性入院状态相关的内在和外在患者因素。使用混淆矩阵和ROC曲线评估模型的性能。结果：在2019年1月至2023年6月使用HARP单元的199例患者中，96例急性出院至医院，103例出院至家庭、SNF或LTAC。在HARP使用者中，最常见的损伤组是脑损伤（22%）、衰弱（21%）和脊髓损伤（18%）。自我护理和活动能力GG评分的改善与成功出院到非急性护理机构有关。结论：非计划出院从康复到急性护理（RTAC）是延长住院时间和增加患者经济负担的一个原因。实施高敏锐度康复计划（HARP）有助于管理临时医疗状况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

American Journal of Physical Medicine & Rehabilitation 医学-康复医学

CiteScore

4.60

自引率

6.70%

发文量

423

审稿时长

1 months

期刊介绍： American Journal of Physical Medicine & Rehabilitation focuses on the practice, research and educational aspects of physical medicine and rehabilitation. Monthly issues keep physiatrists up-to-date on the optimal functional restoration of patients with disabilities, physical treatment of neuromuscular impairments, the development of new rehabilitative technologies, and the use of electrodiagnostic studies. The Journal publishes cutting-edge basic and clinical research, clinical case reports and in-depth topical reviews of interest to rehabilitation professionals. Topics include prevention, diagnosis, treatment, and rehabilitation of musculoskeletal conditions, brain injury, spinal cord injury, cardiopulmonary disease, trauma, acute and chronic pain, amputation, prosthetics and orthotics, mobility, gait, and pediatrics as well as areas related to education and administration. Other important areas of interest include cancer rehabilitation, aging, and exercise. The Journal has recently published a series of articles on the topic of outcomes research. This well-established journal is the official scholarly publication of the Association of Academic Physiatrists (AAP).