Variation in Acute Care Rehabilitation and 30-Day Hospital Readmission or Mortality in Adult Patients with Pneumonia

Freburger JK, Chou A, Euloth T, Matcho B. JAMA Netw Open. 2020;3(9):e2012979. Published 2020 Sep 1. [CrossRef] [PubMed] 

Pneumonia often leads to functional decline during and after hospitalization and is a leading cause of hospital readmissions. Patients from 12 acute care hospitals in a large health care system in western Pennsylvania were analyzed for the number of physical and occupational therapy visits during the acute care stay categorized as none, low (1-3), medium (4-6), or high (>6). Of 30,746 patients, the 30-day readmission rate was 18.4% (5645 patients), the 30-day death rate was 3.7% (1146 patients), and the rate of either outcome was 19.7% (6066 patients). Relative to no therapy visits, the risk of 30-day readmission or death decreased as therapy visits increased (1-3 visits: odds ratio, 0.98; 95%CI, 0.89-1.08; 4-6 visits: odds ratio, 0.89; 95%CI, 0.79-1.01; >6 visits: odds ratio, 0.86; 95%CI, 0.75-0.98). The association was stronger in the subgroup with low functional mobility and in individuals discharged to a community setting. The authors conclude that the number of physical and occupational therapy visits received was inversely associated with the risk of readmission or death. The association was stronger in the subgroups of patients with greater mobility limitations and those discharged to the community.