Goal: To provide an objective basis for weighing the predictive validity of comorbidities in making post-acute placement decisions.
Design: Prospective observational cohort study on two patient groups, stroke (N=1183) and joint replacement (N=1234).
Settings: Skilled nursing facilities (n=9) and inpatient rehabilitation facilities (n=11).
Methods: The study team measured functional status as well as the Comprehensive Severity Index (CSIŽ) on admission, during the inpatient stay, and at discharge. Using correlation and multivariate analyses, we examined the association between the presence of various co-morbidities and the CSI and functional status at discharge. Secondly, we determined a subset of severity indicators for specific co-morbidities that explains most of the variance in the admission CSI. We also measured the actual tiering procedure on co-morbidities for the IRF-PPS against this subset of co-morbidities, in relation to functional status at discharge. For the joint replacement group, we made comparisons on functional status at discharge between patients admitted to a SNF or IRF, taking into account the subset of co-morbidities.
Results: Pending
Conclusions: Pending
Keywords: Comorbidities; 75% rule; PSROP; JOINTS; IRF admission; SNF admission.
Principal Investigator: Gerben DeJong, PhD
Title: Senior Fellow
E-mail: gerben.dejong@medstar.net
Phone: 202-877-1960
Fax: 202-726-7521
Affiliations/partners: ICOR (Institute for Clinical Outcomes Research), Salt Lake City, UT.
Funding Source: The HealthSouth Corporation, ARA Research Institute of the American Rehabilitation Providers Association, Brooks Health, National Rehabilitation Hospital, American Hospital Association, the Federation of American Hospitals, and others.
Project Website
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