Shivayogi V Hiremath1, Mendel Kupfer2,3, Marci Ruediger2. 1. Department of Health and Rehabilitation Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania, USA. 2. Department of Rehabilitation Medicine, Magee Rehabilitation Hospital, Jefferson Health, Philadelphia, Pennsylvania, USA. 3. Department of Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Abstract
BACKGROUND: The rate of readmission in individuals with spinal cord injury (SCI) is known to be high (28% to 45%) during the first year post-injury and post-rehabilitation. However, there are several critical gaps in our knowledge including the timing pattern of medical complications and the pattern of health complications associated with readmissions. OBJECTIVE: To identify the timing and pattern of complications associated with hospital readmissions in individuals with traumatic SCI and non-traumatic spinal cord disorders (SCI) post-discharge from an inpatient rehabilitation facility (IRF). DESIGN: Secondary analysis of a three year prospective cohort study. SETTING: An SCI medical home. PARTICIPANTS: Individuals who were readmitted (n = 53) within the first year (N = 176) post-discharge from an IRF. INTERVENTIONS: N/A. OUTCOME MEASURES: Timing and pattern of all-cause hospital readmissions. RESULTS: Eighty one percent of the readmitted patients experienced readmission within the first six months after discharge, and 36% of the initial readmissions occurred within 30 days of discharge from an IRF. The trend line for the timing of the first readmission post-discharge from an IRF was curvilinear, with a sharp decrease in the number of new patients readmitted for months 1-7 and then a slight increase between 9 and 12 months. Urological and respiratory complications were related to repeat readmissions. CONCLUSION: The patient is at the greatest risk of readmission in the first 6 months, with a secondary increase in risk at 9 months. Possible reasons may include reduction in in-home and outpatient therapy and skilled nursing over the first year post-SCI.
BACKGROUND: The rate of readmission in individuals with spinal cord injury (SCI) is known to be high (28% to 45%) during the first year post-injury and post-rehabilitation. However, there are several critical gaps in our knowledge including the timing pattern of medical complications and the pattern of health complications associated with readmissions. OBJECTIVE: To identify the timing and pattern of complications associated with hospital readmissions in individuals with traumatic SCI and non-traumatic spinal cord disorders (SCI) post-discharge from an inpatient rehabilitation facility (IRF). DESIGN: Secondary analysis of a three year prospective cohort study. SETTING: An SCI medical home. PARTICIPANTS: Individuals who were readmitted (n = 53) within the first year (N = 176) post-discharge from an IRF. INTERVENTIONS: N/A. OUTCOME MEASURES: Timing and pattern of all-cause hospital readmissions. RESULTS: Eighty one percent of the readmitted patients experienced readmission within the first six months after discharge, and 36% of the initial readmissions occurred within 30 days of discharge from an IRF. The trend line for the timing of the first readmission post-discharge from an IRF was curvilinear, with a sharp decrease in the number of new patients readmitted for months 1-7 and then a slight increase between 9 and 12 months. Urological and respiratory complications were related to repeat readmissions. CONCLUSION: The patient is at the greatest risk of readmission in the first 6 months, with a secondary increase in risk at 9 months. Possible reasons may include reduction in in-home and outpatient therapy and skilled nursing over the first year post-SCI.
Entities:
Keywords:
Medical complications; Medical home; Readmission; Spinal cord injury; Urinary tract infections
Authors: Michael D Stillman; Jason Barber; Steve Burns; Steve Williams; Jeanne M Hoffman Journal: Arch Phys Med Rehabil Date: 2017-01-20 Impact factor: 3.966
Authors: Gerben DeJong; Wenqiang Tian; Ching-Hui Hsieh; Cherry Junn; Christopher Karam; Pamela H Ballard; Randall J Smout; Susan D Horn; Jeanne M Zanca; Allen W Heinemann; Flora M Hammond; Deborah Backus Journal: Arch Phys Med Rehabil Date: 2013-04 Impact factor: 3.966