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Comparing Comorbidity Indices to Predict Post-Acute Rehabilitation Outcomes in Older Adults
- Publication Year :
- 2016
-
Abstract
- Compare 5 comorbidity indices to predict community discharge and functional status following post-acute rehabilitation.This was a retrospective study of Medicare beneficiaries with stroke, lower-extremity fracture, and joint replacement discharged from inpatient rehabilitation in 2011 (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.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 (R) 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. R 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%.Comorbidity indices were poor predictors of community discharge and functional status in Medicare beneficiaries receiving inpatient rehabilitation.
- Subjects :
- Male
medicine.medical_specialty
Activities of daily living
Joint replacement
medicine.medical_treatment
Health Status
MEDLINE
Physical Therapy, Sports Therapy and Rehabilitation
Comorbidity
Medicare
Article
03 medical and health sciences
Fractures, Bone
0302 clinical medicine
Predictive Value of Tests
Activities of Daily Living
medicine
Humans
030212 general & internal medicine
Arthroplasty, Replacement
Stroke
Aged
Retrospective Studies
Aged, 80 and over
business.industry
Rehabilitation
Stroke Rehabilitation
Retrospective cohort study
Recovery of Function
medicine.disease
Arthroplasty
United States
Hospitalization
Treatment Outcome
Predictive value of tests
Physical therapy
Female
business
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....1b5de6c1a026dc9646ddf9775ee221bf