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Comparing Comorbidity Indices to Predict Post-Acute Rehabilitation Outcomes in Older Adults.
- Source :
-
American Journal of Physical Medicine & Rehabilitation . Dec2016, Vol. 95 Issue 12, p889-898. 10p. - Publication Year :
- 2016
-
Abstract
- Objective: Compare 5 comorbidity indices to predict community discharge and functional status following post-acute rehabilitation. Design: This was a retrospective study of Medicare beneficiaries with stroke, lower-extremity fracture, and joint replacement discharged from inpatient rehabilitation in 201 1 (N = 105,275). Community discharge and self-care, mobility, and cognitive function were compared using the Charlson, Elixhauser, Tier, Functional Comorbidity, and Hierarchical Condition Category comorbidity indices. Results: Of the patients, 64.4% were female, and 84.6% were non-Hispanic white. Mean age was 79.3 (SD, 7.5) years. Base regression models including sociodemographic and clinical variables explained 56.6%, 42.2%, and 23.0% of the variance (R²) for discharge self-care; 47.4%, 30.9%, and 18.6% for mobility; and 62.0%, 55.3%, and 37.3% for cognition across the 3 impairment groups. R² values for self-care, mobility, and cognition increased by 0.2% to 3.3% when the comorbidity indices were added to the models. The base model C statistics for community discharge were 0.58 (stroke), 0.61 (fracture), and 0.62 (joint replacement). The C statistics increased more than 25% with the addition of discharge functional status to the base model. Adding the comorbidity indices individually to the base model resulted in C-statistic increases of 1 % to 2%. Conclusion: Comorbidity indices were poor predictors of community discharge and functional status in Medicare beneficiaries receiving inpatient rehabilitation. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ARTIFICIAL joints
*COGNITION
*BONE fractures
*LIFE skills
*MEDICARE
*REGRESSION analysis
*REHABILITATION centers
*RESEARCH funding
*HEALTH self-care
*COMORBIDITY
*LOGISTIC regression analysis
*DISCHARGE planning
*GERIATRIC rehabilitation
*RETROSPECTIVE studies
*RECEIVER operating characteristic curves
*DATA analysis software
*STROKE rehabilitation
*DESCRIPTIVE statistics
Subjects
Details
- Language :
- English
- ISSN :
- 08949115
- Volume :
- 95
- Issue :
- 12
- Database :
- Academic Search Index
- Journal :
- American Journal of Physical Medicine & Rehabilitation
- Publication Type :
- Academic Journal
- Accession number :
- 119562791
- Full Text :
- https://doi.org/10.1097/PHM.0000000000000527