Myopathy as a principal admitting diagnosis, compared to neurological disorders, increased the likelihood of transfer to subacute or short-term hospital care (RRR 2.18; 95% CI 1.41-3.37).
Cohort (n=3,446)
Yes
Does the principal admitting diagnosis affect discharge destination in patients aged 60 years or older admitted to rehabilitation hospitals from long-term care facilities?
In older patients transitioning from long-term care to rehabilitation hospitals, principal admitting diagnoses significantly influence discharge destinations, highlighting the need for diagnosis-tailored discharge planning.
Effect estimate: RRR 2.18 (95% CI 1.41-3.37)
Abstract Background and Objectives Hospitalization outcomes of long-term care facility (LTCF) residents aged 60 years or older who are admitted to rehabilitation hospitals may differ by diagnosis at admission. This study aimed to determine the relationship between principal admitting diagnoses and discharge destination and the role of length of stay (LoS) and comorbid conditions. Research Design and Methods This retrospective cohort study utilized the Texas Inpatient Public Use Data File from October 2022 to June 2024. The cohort included 3,446 patients admitted to rehabilitation hospitals from LTCFs. Discharge destination (five-level) was modeled with multinomial logistic regression adjusting for age, gender, race/ethnicity, and health insurance status. Results Neurological disorders (20.0%) and myopathies (20.2%) were the most common principal admitting diagnoses. Compared with neurological disorders, myopathies had a higher likelihood of transferring to subacute or short-term hospital care (RRR = 2.18, 95% CI : 1.41-3.37) and home under care (RRR = 1.69, 95% CI : 1.21-2.36). General symptoms or functional impairments were similarly associated with higher relative risk of discharge from acute to short-term care hospitals (RRR = 2.05, 95% CI : 1.13-3.72) and home under care (RRR = 1.73, 95% CI : 1.08-2.77). Post-surgical or orthopedic aftercare had lower relative risk of discharge to skilled nursing rather than rehabilitation hospital facilities (RRR = 0.50, 95% CI : 0.28-0.88). Discussion and Implications Among patients admitted to rehabilitation hospitals from LTCFs, a neurological principal admitting diagnosis and extended LoS with comorbid conditions carry a higher likelihood of discharge to an intensive care facility. These findings suggest a need for proactive admission diagnosis-tailored discharge planning and attention for patients with extended LoS.
Yin et al. (Sat,) conducted a cohort in Patients admitted to rehabilitation hospitals from long-term care facilities (n=3,446). Principal admitting diagnosis (myopathies) vs. Neurological disorders was evaluated on Discharge destination (transfer to subacute or short-term hospital care) (RRR 2.18, 95% CI 1.41-3.37). Myopathy as a principal admitting diagnosis, compared to neurological disorders, increased the likelihood of transfer to subacute or short-term hospital care (RRR 2.18; 95% CI 1.41-3.37).