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The association of discharge destination with 30-day rehospitalization rates among older adults receiving lumbar spinal fusion surgery.

Publication ,  Journal Article
Cook, C; Coronado, RA; Bettger, JP; Graham, JE
Published in: Musculoskelet Sci Pract
April 2018

BACKGROUND: As defined by Medicare (United States), post-acute rehabilitation services include care provided in inpatient rehabilitation units and facilities, skilled nursing facilities, long-term acute hospitals, and by home health services. METHODS: We retrospectively evaluated the use of rehabilitation-based post-acute services among Medicare beneficiaries who were hospitalized for lumbar spinal fusion (ICD-9-CM procedure codes 81.04-81.08) in 2012-2014, examined the case-mix for those discharged to rehabilitation- and non-rehabilitation based services, and determined the association between these categories of discharge disposition and 30-day rehospitalization. The independent effect of rehabilitation-based discharge destination on 30-day readmissions was examined with a generalized linear mixed model, first adjusting for patient characteristics and then stratified by clusters that delineated more homogenous clinical profiles. RESULTS: Among 261,558 Medicare beneficiaries with lumbar spinal fusion surgery, 50.8% were discharged to a rehabilitation-based post-acute services. Patients discharged to rehabilitation-based services were older and had more comorbidities, and had longer hospital lengths of stays. After adjusting for patient and hospital characteristics, patients discharged to rehabilitation-based post-acute care had increased odds of 30-day rehospitalization than those without discharge to other destinations (OR 1.36; 95%CI = 1.31, 1.40). Analysis of patients by clinical profile clusters found similar results. CONCLUSIONS: Clinical profiles of Medicare beneficiaries who had lumbar spinal fusion surgery and were discharged to rehabilitation-based post-acute services included more comorbidities than those discharged to non-rehabilitation based settings. Controlling for these differences did not mediate the negative association between use of rehabilitation-based post-acute services and 30-day readmission.

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Published In

Musculoskelet Sci Pract

DOI

EISSN

2468-7812

Publication Date

April 2018

Volume

34

Start / End Page

77 / 82

Location

Netherlands

Related Subject Headings

  • United States
  • Spinal Fusion
  • Skilled Nursing Facilities
  • Retrospective Studies
  • Rehabilitation Centers
  • Patient Readmission
  • Patient Discharge
  • Odds Ratio
  • Middle Aged
  • Medicare
 

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ICMJE
MLA
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Cook, C., Coronado, R. A., Bettger, J. P., & Graham, J. E. (2018). The association of discharge destination with 30-day rehospitalization rates among older adults receiving lumbar spinal fusion surgery. Musculoskelet Sci Pract, 34, 77–82. https://doi.org/10.1016/j.msksp.2018.01.003
Cook, Chad, Rogelio A. Coronado, Janet Prvu Bettger, and James E. Graham. “The association of discharge destination with 30-day rehospitalization rates among older adults receiving lumbar spinal fusion surgery.Musculoskelet Sci Pract 34 (April 2018): 77–82. https://doi.org/10.1016/j.msksp.2018.01.003.
Cook C, Coronado RA, Bettger JP, Graham JE. The association of discharge destination with 30-day rehospitalization rates among older adults receiving lumbar spinal fusion surgery. Musculoskelet Sci Pract. 2018 Apr;34:77–82.
Cook, Chad, et al. “The association of discharge destination with 30-day rehospitalization rates among older adults receiving lumbar spinal fusion surgery.Musculoskelet Sci Pract, vol. 34, Apr. 2018, pp. 77–82. Pubmed, doi:10.1016/j.msksp.2018.01.003.
Cook C, Coronado RA, Bettger JP, Graham JE. The association of discharge destination with 30-day rehospitalization rates among older adults receiving lumbar spinal fusion surgery. Musculoskelet Sci Pract. 2018 Apr;34:77–82.
Journal cover image

Published In

Musculoskelet Sci Pract

DOI

EISSN

2468-7812

Publication Date

April 2018

Volume

34

Start / End Page

77 / 82

Location

Netherlands

Related Subject Headings

  • United States
  • Spinal Fusion
  • Skilled Nursing Facilities
  • Retrospective Studies
  • Rehabilitation Centers
  • Patient Readmission
  • Patient Discharge
  • Odds Ratio
  • Middle Aged
  • Medicare