دورية أكاديمية
Association Between Hospital Participation in Value-Based Programs and Timely Initiation of Post-Acute Home Health Care, Functional Recovery, and Hospital Readmission After Joint Replacement.
| العنوان: | Association Between Hospital Participation in Value-Based Programs and Timely Initiation of Post-Acute Home Health Care, Functional Recovery, and Hospital Readmission After Joint Replacement. |
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| المؤلفون: | Roy I; Department of Health Sciences, Center for Health Equity Research, Northern Arizona University, Flagstaff, Arizona, USA., Karmarkar AM; Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.; Sheltering Arms Institute, Richmond, Virginia, USA., Lininger MR; Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, Arizona, USA., Jain T; Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, Arizona, USA., Martin BI; Department of Orthopedics, University of Utah, Salt Lake City, Utah, USA., Kumar A; Department of Physical Therapy and Athletic Training, College of Health, University of Utah, Salt Lake City, Utah, USA.; Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA. |
| المصدر: | Physical therapy [Phys Ther] 2023 Dec 06; Vol. 103 (12). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: United States NLM ID: 0022623 Publication Model: Print Cited Medium: Internet ISSN: 1538-6724 (Electronic) Linking ISSN: 00319023 NLM ISO Abbreviation: Phys Ther Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2017- : New York : Oxford University Press Original Publication: Alexandria, VA : American Physical Therapy Association |
| مواضيع طبية MeSH: | Patient Readmission* , Arthroplasty, Replacement, Hip*, Humans ; Aged ; United States ; Retrospective Studies ; Medicare ; Hospitals |
| مستخلص: | Objectives: This study examined the association between hospital participation in Bundled Payments for Care Improvement (BPCI) or Comprehensive Care for Joint Replacement (CJR) and the timely initiation of home health rehabilitation services for lower extremity joint replacements. Furthermore, this study examined the association between the timely initiation of home health rehabilitation services with improvement in self-care, mobility, and 90-day hospital readmission. Method: This retrospective cohort study used Medicare inpatient claims and home health assessment data from 2016 to 2017 for older adults discharged to home with home health following hospitalization after joint replacement. Multilevel multivariate logistic regression was used to examine the association between hospital participation in BPCI or CJR programs and timely initiation of home health rehabilitation service. A 2-staged generalized boosted model was used to examine the association between delay in home health initiation and improvement in self-care, mobility, and 90-day risk-adjusted hospital readmission. Results: Compared with patients discharged from hospitals that did not have BPCI or CJR, patients discharged from hospitals with these programs had a lower likelihood of delayed initiation of home health rehabilitation services for both knees and hip replacement. Using propensity scores as the inverse probability of treatment weights, delay in the initiation of home health rehabilitation services was associated with lower improvement in self-care (odds ratio [OR] = 1.23; 95% CI = 1.20-1.26), mobility (OR = 1.15; 95% CI = 1.13-1.18), and higher rate of 90-day hospital readmission (OR = 1.19; 95% CI = 1.15-1.24) for knee replacement. Likewise, delayed initiation of home health rehabilitation services was associated with lower improvement in self-care (OR = 1.16; 95% CI = 1.13-1.20) and mobility (OR = 1.26; 95% CI = 1.22-1.30) for hip replacement. Conclusion: Hospital participation in BPCI or comprehensive CJR was associated with early home health rehabilitation care initiation, which was further associated with significant increases in functional recovery and lower risks of hospital readmission. Impact: Policy makers may consider incentivizing health care providers to initiate early home health services and care coordination in value-based payment models. (© The Author(s) 2023. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.) |
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| معلومات مُعتمدة: | P2C HD065702 United States HD NICHD NIH HHS; U54 MD012388 United States MD NIMHD NIH HHS; R03AG060345 United States NH NIH HHS |
| فهرسة مساهمة: | Keywords: Arthroplasty; Bundle Payment; Mobility; Rehabilitation; Rehospitalization; Self-Care |
| تواريخ الأحداث: | Date Created: 20230911 Date Completed: 20231216 Latest Revision: 20231216 |
| رمز التحديث: | 20231217 |
| مُعرف محوري في PubMed: | PMC10715680 |
| DOI: | 10.1093/ptj/pzad123 |
| PMID: | 37694820 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1538-6724 |
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| DOI: | 10.1093/ptj/pzad123 |