Abstract
Objectives
Our study examines factors associated with patient-reported outcomes in functioning
among Medicare beneficiaries who reported receiving rehabilitation services in a nursing
home or inpatient (ie, hospital or rehabilitation facility) setting in the prior year.
Design
Data are from the 2015 and 2016 rounds of the National Health and Aging Trends Study
(NHATS), a longitudinal study of a nationally representative sample of Medicare beneficiaries
aged 65 years and older.
Setting and Participants
A total of 479 participants in the 2016 sample who reported receiving rehabilitation
services in a nursing home or inpatient setting in the past year.
Measures
Bivariate and logistic regression analyses examined the association of demographic,
socioeconomic status, and health variables (from the 2015 interview) and rehabilitation
characteristics (from the 2016 interview) with patient-reported improvement in “functioning
and ability to do activities” while receiving rehabilitation services in the past
year.
Results
Among Medicare beneficiaries who received rehabilitation services in nursing home
or inpatient settings, 33.4% (weighted percent) reported no improvement in functioning
while they were receiving rehabilitation. In a regression analysis that accounted
for demographics, those with a high school education or less (compared with those
with a college degree), instrumental activities of daily living impairments, certain
primary conditions for rehabilitation, less than 1-month total duration of rehabilitation
services, and no outpatient rehabilitation services had greater odds of reporting
no improvement.
Conclusions/Implications
Our weighted sample represents approximately 2.3 million Medicare beneficiaries who
received rehabilitation services in nursing home or inpatient settings. In this sample,
1 in 3 reported no improvement in functioning, with differences in patient-reported
outcomes across socioeconomic status, health status, and rehabilitation characteristics
domains. Consideration of characteristics across these domains may be clinically pertinent,
but investigation as to why these differences are present and whether services can
be optimized to further improve patient-reported outcomes is warranted.
Keywords
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Article info
Publication history
Published online: July 25, 2018
Footnotes
The authors declare no conflicts of interest.
The National Health and Aging Trends Study dataset is publicly available and is sponsored by the National Institute on Aging (grant number NIA U01AG032947) through a cooperative agreement with the Johns Hopkins Bloomberg School of Public Health. Available at www.nhats.org. AS was supported through the Empire Clinical Research Investigator Program, sponsored by the New York State Department of Health. The funders had no role in our article's design, data analysis, decision to publish, or preparation of the manuscript.
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© 2018 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
