Abstract
Objectives
To quantify the rate of readmission from inpatient rehabilitation facilities (IRFs)
to acute care hospitals (ACHs) during the first 30 days of rehabilitation stay. To
measure variation in 30-day readmission rate across IRFs, and the extent that patient
and facility characteristics contribute to this variation.
Design
Retrospective analysis of an administrative database.
Setting and Participants
Adult IRF discharges from 944 US IRFs captured in the Uniform Data System for Medical
Rehabilitation database between October 1, 2015 and December 31, 2017.
Methods
Multilevel logistic regression was used to calculate adjusted rates of readmission
within 30 days of IRF admission and examine variation in IRF readmission rates, using
patient and facility-level variables as predictors.
Results
There were a total of 104,303 ACH readmissions out of a total of 1,102,785 IRFs discharges.
The range of 30-day readmission rates to ACHs was 0.0%‒28.9% (mean = 8.7%, standard
deviation = 4.4%). The adjusted readmission rate variation narrowed to 2.8%‒17.5%
(mean = 8.7%, standard deviation = 1.8%). Twelve patient-level and 3 facility-level
factors were significantly associated with 30-day readmission from IRF to ACH. A total
of 82.4% of the variance in 30-day readmission rate was attributable to the model
predictors.
Conclusions and Implications
Fifteen patient and facility factors were significantly associated with 30-day readmission
from IRF to ACH and explained the majority of readmission variance. Most of these
factors are nonmodifiable from the IRF perspective. These findings highlight that
adjusting for these factors is important when comparing readmission rates between
IRFs.
Keywords
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Article info
Publication history
Published online: May 10, 2021
Footnotes
The contents of this manuscript were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant numbers 90DPBU0001, 90DPTB0011, 90SI5021). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this manuscript do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.
The authors declare no conflicts of interest.
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© 2021 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
