Article

OBJECTIVES: To model 12-month rehospitalization risk among Medicare beneficiaries
receiving inpatient rehabilitation for spinal cord injury (SCI) or traumatic
brain injury (TBI) and to create 2 (SCI- and TBI-specific) interactive tools
enabling users to generate monthly projected probabilities of rehospitalization
on the basis of an individual patient's clinical profile at discharge from
inpatient rehabilitation.
DESIGN: Secondary data analysis. SETTING: Inpatient
rehabilitation facilities. PARTICIPANTS: Medicare beneficiaries receiving
inpatient rehabilitation for SCI (n=2587) or TBI (n=10,864). INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: Monthly rehospitalization (yes/no) based on
Medicare claims. RESULTS: Results are summarized through computer-generated
interactive tools, which plot individual level trajectories of rehospitalization
probabilities over time. Factors associated with the probability of
rehospitalization over time are also provided, with different combinations of
these factors generating different individual level trajectories. Four case
studies are presented to demonstrate the variability in individual risk
trajectories. Monthly rehospitalization probabilities for the individual
high-risk TBI and SCI cases declined from 33% to 15% and from 41% to 18%,
respectively, over time, whereas the probabilities for the individual low-risk
cases were much lower and stable over time: 5% to 2% and 6% to 2%, respectively.
CONCLUSIONS: Rehospitalization is an undesirable and multifaceted health outcome.
Classifying patients into meaningful risk strata at different stages of their
recovery is a positive step forward in anticipating and managing their unique
health care needs over time.
CI - Copyright (c) 2017 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS