Impact of Acute Self-Care Indicators and Social Factors on Medicare Inpatient Readmission Risk

Abstract

Importance: Readmissions are costly for Medicare and are associated with poor patient outcomes. Objective: To determine whether two domains relevant to acute occupational therapy practice—self-care status and social factors—were associated with readmissions for Medicare patients in the Medicare Hospital Readmissions Reduction Program (HRRP). Design: Cross-sectional, retrospective study. Setting: Single academic medical center. Participants: Medicare inpatients with a diagnosis included in the HRRP (N = 17,618). Outcomes and Measures: Three logistic regression models were estimated to examine the associations among (1) self-care status and 30-day readmission, (2) social support and 30-day readmission, and (3) housing situation and 30-day readmission. Subgroup analyses were conducted for the individual HRRP diagnoses. Results: No associations were found between acute self-care status, social support, or housing situation and 30-day readmission when all HRRP diagnoses were examined together. However, higher levels of independence with self-care were significantly associated with reduced odds of readmission for patients with pneumonia. Conclusions and Relevance: The findings for patients with pneumonia are consistent with those of other studies done in the acute care setting. Deficiencies in acute occupational therapy documentation may have affected the findings for the other HRRP diagnoses. What This Article Adds: This study is the first to examine the association between acute self-care status (as documented by acute care occupational therapy practitioners) and readmission.