Use of Rehabilitation and Other Health Care Services by Patients With Joint Replacement After Discharge From Skilled Nursing and Inpatient Rehabilitation Facilities
| Autor: | Joan E. DaVanzo, Julie Gassaway, Pamela M. Smith, Koen Putman, Wenqiang Tian, Susan D. Horn, Gerben DeJong, Randall J. Smout |
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| Přispěvatelé: | Medical Sociology, Rehabilitation Research |
| Rok vydání: | 2009 |
| Předmět: |
Occupational therapy
medicine.medical_specialty Rehabilitation Rehabilitation centers business.industry Joint replacement Arthroplasty Replacement Hip medicine.medical_treatment Psychological intervention Knee replacement Physical Therapy Sports Therapy and Rehabilitation Hospital readmission UTILIZATION Skilled Nursing facilities Arthroplasty Hip replacement Health care medicine Physical therapy Arthroplasty Replacement Knee business |
| Zdroj: | Archives of Physical Medicine and Rehabilitation. 90:1297-1305 |
| ISSN: | 0003-9993 |
| DOI: | 10.1016/j.apmr.2008.12.029 |
| Popis: | DeJong G, Tian W, Smout RJ, Horn SD, Putman K, Smith P, Gassaway J, DaVanzo JE. Use of rehabilitation and other health care services by patients with joint replacement after discharge from skilled nursing and inpatient rehabilitation facilities. Objective To compare use of rehabilitation and other health services among patients with knee and hip replacement after discharge from a skilled nursing facility (SNF) or an inpatient rehabilitation facility (IRF). Design Follow-up interview study at 7.5 months after discharge. Setting Five freestanding SNFs, 1 hospital-based SNF, and 6 IRFs from across the United States. Participants Patients (N=856): patients with knee replacement (n=561) and patients with hip replacement (n=295). Interventions No interventions. Main Outcome Measures Number of home and outpatient therapy visits, physician visits, emergency room visits, rehospitalizations, and medical complications. Results After discharge from postacute care, the vast majority of patients received home rehabilitation, outpatient rehabilitation, or both. Patients with knee replacement received an average of 19 home and/or outpatient rehabilitation visits; patients with hip replacement received almost 15 visits. There were no statistically significant differences in rates of emergency room use and rehospitalization except that patients with hip replacement discharged from IRFs had higher rates of rehospitalization than those discharged from freestanding SNFs (15.8% vs 3.1%). Multivariate analyses did not find any SNF/IRF effects. Conclusions Patients with joint replacement from both SNFs and IRFs receive considerable amounts of follow-up rehabilitation care. Study uncovered no setting effects related to rehospitalization or medical complications. Looking only at care rendered in the initial postacute setting provides an incomplete picture of all care received and how it may affect follow-up outcomes. |
| Databáze: | OpenAIRE |
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