| Predictors of Hospital Readmission for Patients Post-SNF discharged to Homes and Residential Care Facilities in a Post-Acute Care Setting |
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Second Place Poster Winnerby Andrew Wang M.D., Alex Wang B.S., Austin Wang B.A., Parag Agnihotri M.D.Sharp Extended Care, Sharp Health Care. Arbor Hills Skilled Nursing Rehabilitation Center, Generations Health Care
Summary Post-SNF 30-day hospital readmissions are more likely to occur in male, cognitively impaired, lower-functioning patients. Allen Cognitive Level placemat test is a useful tool to stratify patients of higher risk for readmission. Caregiver guides for patients at different impairment levels can facilitate home health care in various aspects of activities of daily living. Further testing is required to validate the effect. 1. Introduction and Objectives Hospital readmissions put patients at risk for complications, and are expensive. In a skilled nursing facility (SNF) 30-day potentially preventable readmission measure, the readmission may occur after the patient is discharged from the SNF. A majority of patients in the post-acute care SNF setting are discharged to homes and residential care facilities which include assisted living, and board and care. The objectives of this study are as follows: 1) Which patient characteristics are better indicators of hospital readmissions for patients post-SNF discharged? 2) Whether the disposition to residential care facilities increases risk of hospital readmissions? 3) What is the likelihood of hospital readmissions for patients who are discharged to homes vs residential care facilities? 2. Methods A cross-sectional study was conducted on 212 patients who were discharged home (n=159) or to residential care facilities (n=53) after post-acute care rehabilitation between January 1, 2016 and November 30, 2016. Patients admitted for IV antibiotic therapy or stayed at SNF 6 days or less were excluded from the study (Figure 1). Patient characteristics (Table 1) included age, gender, Allen Cognitive Levels placemat test (ACL), body mass index (BMI), functional independent measures score (FIM) prior to discharge (Table 2), length of stay (LOS), Saint Louis University Mental Status (SLUMS) score, and Initial Admitting Diagnosis (Graph 1). 3. Results
4. Discussion and Conclusions
Studies have shown that living situation, marriage status, social support, wealth and race are associated with hospital readmission. Providing patients with enhanced post-discharge instructions and/or support is the most commonly endorsed preventive strategies. Multifaceted broadly applied interventions may be more successful than those that rely on individual providers choosing specific services based on perceived risk factors. (Ref. 2, 3) 5. Summary Post-SNF 30-days hospital readmissions are more likely to occur in male, cognitively impaired, lower functioning patients. Allen Cognitive Level placemat test is a useful tool to stratify patients of higher risk for readmission. Caregiver guides for patients at different impaired levels can facilitate home health care in various aspects of activities of daily living. Further testing is required to validate the effect. 6. References
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