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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 76 Research Studies Displayed
Graber J, Lockhart S, Matlock DD
"This is not negotiable. You need to do this…": a directed content analysis of decision making in rehabilitation after knee arthroplasty.
In this qualitative study, researchers sought to understand patients' and physical therapists' perspectives related to decision making during outpatient rehabilitation after total knee arthroplasty (TKA) and further to describe potential barriers and opportunities for shared decision making (SDM) in this setting. They found that physical therapists described using decision-making strategies with varying levels of patient involvement, while both patients and physical therapists described barriers to routine use of SDM in the outpatient setting. They also presented actionable strategies for overcoming these barriers for providers and organizations seeking consistently to use SDM in outpatient TKA rehabilitation.
AHRQ-funded; HS025692.
Citation:
Graber J, Lockhart S, Matlock DD .
"This is not negotiable. You need to do this…": a directed content analysis of decision making in rehabilitation after knee arthroplasty.
J Eval Clin Pract 2022 Feb;28(1):99-107. doi: 10.1111/jep.13591..
Keywords:
Decision Making, Rehabilitation, Orthopedics, Surgery, Patient-Centered Healthcare
Davidson L, Haynes SC, Favila-Meza A
Parent experience and cost savings associated with a novel tele-physiatry program for children living in rural and underserved communities.
This study investigated patient and therapist experience and cost savings from the payer perspective associated with a novel tele-physiatry program for children living in rural and underserved communities. Study setting was four school-based clinics in Northern California with a total of 268 encounters (124 telemedicine and 144 in-person). Parent and therapists reported no difference in experience and perceived quality of care between telemedicine and in-person encounters. For parents whose children received a telemedicine encounter, 54.8% reported no preference for their child’s subsequent encounter, 28.8% preferred a physiatrist telemedicine visit, and 12 preferred a physiatrist in-person visit. There was also an average cost savings of $100 per clinic owing to physician milage for in-person visits.
AHRQ-funded; HS025714.
Citation:
Davidson L, Haynes SC, Favila-Meza A .
Parent experience and cost savings associated with a novel tele-physiatry program for children living in rural and underserved communities.
Arch Phys Med Rehabil 2022 Jan;103(1):8-13. doi: 10.1016/j.apmr.2021.07.807..
Keywords:
Children/Adolescents, Telehealth, Health Information Technology (HIT), Healthcare Costs, Rural Health, Vulnerable Populations, Disabilities, Rehabilitation
Kittelson AJ, Loyd BJ, Graber J
Examination of exclusion criteria in total knee arthroplasty rehabilitation trials: influence on the application of evidence in day-to-day practice.
This study investigated whether total knee arthroplasty (TKA) patients seen in routine practice who meet common exclusion criteria in clinical trials recover differently compared to research-eligible patients. Postoperative functional outcomes were compared using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Timed Up and Go (TUG). A total of 2,528 participants from 27 trials were compared to 474 patients from the clinical dataset. Research participants were older, with lower BMI than patients in the clinical dataset. There were no differences observed in functional recovery rate between groups, except for patients with diabetes whose TUG recovered more slowly than “eligible” patients.
AHRQ-funded; HS024316.
Citation:
Kittelson AJ, Loyd BJ, Graber J .
Examination of exclusion criteria in total knee arthroplasty rehabilitation trials: influence on the application of evidence in day-to-day practice.
J Eval Clin Pract 2021 Dec;27(6):1335-42. doi: 10.1111/jep.13564..
Keywords:
Orthopedics, Surgery, Rehabilitation, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes
Capo-Lugo CE, Askew RL, Boebel M
A comparative approach to quantifying provision of acute therapy services.
This study’s objective was to compare delivery of acute rehabilitation therapy using metrics reflecting distinct aspects of rehabilitation therapy services. Seven general medical-surgical hospitals in Illinois and Indiana prospectively collected de-identified rehabilitation therapy data. The data looked at 35,449 patients who received any type of acute rehabilitation therapy. Metrics recorded by therapists included therapy types, total minutes, and minutes per day (intensity). Extended hospital stay was defined as length of stay (LOS) longer than Medicare’s geometric mean LOS. The odds of an extended hospital stay increased with increased number of minutes, increased number of therapy types, and decreased with increased rehabilitation intensity.
AHRQ-funded; HS000078.
Citation:
Capo-Lugo CE, Askew RL, Boebel M .
A comparative approach to quantifying provision of acute therapy services.
Medicine 2021 Oct 8;100(40):e27377. doi: 10.1097/md.0000000000027377.
AHRQ-funded; HS000078..
AHRQ-funded; HS000078..
Keywords:
Rehabilitation, Healthcare Delivery
Hou Y, Bushnell CD, Duncan PW
Hospital to home transition for patients with stroke under bundled payments.
In this paper, the authors describe COMprehensive Post-Acute Stroke Services (COMPASS), a comprehensive transitional care intervention focused on discharge from the acute care setting to home. The COMPASS care model is aligned with the incentive structures and essential components of bundled payments in terms of care coordination, patient assessment, patient and family involvement, and continuity of care. They concluded that ongoing evaluation will inform the design of incorporating COMPASS-like transitional care interventions into a stroke bundle.
AHRQ-funded; R01 HS025723.
Citation:
Hou Y, Bushnell CD, Duncan PW .
Hospital to home transition for patients with stroke under bundled payments.
Arch Phys Med Rehabil 2021 Aug;102(8):1658-64. doi: 10.1016/j.apmr.2021.03.010..
Keywords:
Transitions of Care, Stroke, Cardiovascular Conditions, Rehabilitation, Care Coordination
Pritchard KT, Baillargeon J, Raji Ma
Association of occupational and physical therapy with duration of prescription opioid use after hip or knee arthroplasty: A retrospective cohort study of Medicare enrollees.
The purpose of this study was to establish whether non-pharmacological interventions, such as occupational and physical therapy, were associated with a shorter duration of prescription opioid use after hip or knee arthroplasty. The investigators concluded that occupational and physical therapy with home health were associated with a shorter duration of prescription opioid use after hip and knee arthroplasty.
AHRQ-funded; HS026133.
Citation:
Pritchard KT, Baillargeon J, Raji Ma .
Association of occupational and physical therapy with duration of prescription opioid use after hip or knee arthroplasty: A retrospective cohort study of Medicare enrollees.
Arch Phys Med Rehabil 2021 Jul;102(7):1257-66. doi: 10.1016/j.apmr.2021.01.086..
Keywords:
Orthopedics, Surgery, Opioids, Pain, Rehabilitation, Practice Patterns
Clair K, Ijadi-Maghsoodi R, Nazinyan M
Veteran perspectives on adaptations to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic.
This paper looks at veterans’ perspectives on adaptations made to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic. Adaptations to services are described within a large residential rehabilitation program for under-resourced veterans; reports veterans’ experiences; and outlines successes and challenges encountered. Data was collected from two focus groups with nine veterans in the program. The groups highlighted experiences of inconsistent communication about residential policies, interruptions to medical and addiction services, and feelings of confinement and social isolation.
AHRQ-funded; HS026407.
Citation:
Clair K, Ijadi-Maghsoodi R, Nazinyan M .
Veteran perspectives on adaptations to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic.
Community Ment Health J 2021 Jul;57(5):801-07. doi: 10.1007/s10597-021-00810-z..
Keywords:
Veterans, Substance Abuse, Rehabilitation, COVID-19, Healthcare Delivery, Access to Care, Patient Experience
Anderson MC, Evans E, Zonfrillo MR
Rural/urban differences in discharge from rehabilitation in older adults with traumatic brain injury.
This study compared differences in outcomes for older adults with traumatic brain injury (TBI) in rural and urban settings by 1) comparing the rates of successful community discharge; and 2) reasons for not achieving successful discharge. This retrospective national cohort study looked at skilled nursing facility (SNF) patients aged 66 and older using Medicare inpatient claims with Minimum Data Set assessments. A total of 11,771 SNFs were identified with a total population of 61,021 Medicare beneficiaries discharged to a SNF following hospitalization for TBI between 2011 and 2015. Patients in rural settings had lower rates of successful discharge compared with patients in urban settings (52.1% vs 58.5%). Reasons for unsuccessful discharge differed between rural and urban settings with rural patients less likely to discharged from SNF within 100 days although they were less likely to be rehospitalized within 30 days of SNF discharge.
AHRQ-funded; HS000011.
Citation:
Anderson MC, Evans E, Zonfrillo MR .
Rural/urban differences in discharge from rehabilitation in older adults with traumatic brain injury.
J Am Geriatr Soc 2021 Jun;69(6):1601-08. doi: 10.1111/jgs.17065..
Keywords:
Elderly, Brain Injury, Trauma, Rural Health, Urban Health, Rehabilitation, Nursing Homes
Reistetter TA, Eschbach K K, Prochaska J
Understanding variation in postacute care: developing rehabilitation service areas through geographic mapping.
This study’s goal was to demonstrate a method for developing rehabilitation service areas for post-acute care. A secondary analysis of 2013-2014 Medicare records for older patients in Texas (n = 469,172) was conducted. The analysis included admission records for inpatient rehabilitation facilities, skilled nursing facilities, and long-term care hospitals. The authors used Ward’s algorithm to cluster patient ZIP code tabulation areas based on which facilities patients were admitted to for rehabilitation. They set the number of rehabilitation clusters to 22 to allow for comparison to the 22 hospital referral regions. Interclass Correlation Coefficient (ICC) and variance in the number of rehabilitation beds across areas were the methods used to evaluate rehabilitation service areas. The service areas had a higher ICC and variance in beds than the hospital referral regions.
AHRQ-funded; HS024711.
Citation:
Reistetter TA, Eschbach K K, Prochaska J .
Understanding variation in postacute care: developing rehabilitation service areas through geographic mapping.
Am J Phys Med Rehabil 2021 May;100(5):465-72. doi: 10.1097/phm.0000000000001577..
Keywords:
Elderly, Rehabilitation, Medicare, Nursing Homes, Long-Term Care, Home Healthcare, Access to Care
Bush M, Kucharska-Newton A, Simpson RJ
Effect of initiating cardiac rehabilitation after myocardial infarction on subsequent hospitalization in older adults.
Outpatient cardiac rehabilitation (CR) participation after myocardial infarction (MI) reduces all-cause mortality; however, less is known about effects of CR on post-MI hospitalization. The objective of this study was to investigate effects of CR on hospitalization following acute MI among older adults. The investigators concluded that this study provided evidence that CR could reduce the 1-yr risk of cardiovascular and all-cause hospital admissions in Medicare aged MI survivors.
AHRQ-funded; HS000032.
Citation:
Bush M, Kucharska-Newton A, Simpson RJ .
Effect of initiating cardiac rehabilitation after myocardial infarction on subsequent hospitalization in older adults.
J Cardiopulm Rehabil Prev 2020 Mar;40(2):87-93. doi: 10.1097/hcr.0000000000000452..
Keywords:
Elderly, Rehabilitation, Heart Disease and Health, Cardiovascular Conditions, Hospitalization
Evans E, Kosar CM, Thomas KS
Positive beliefs and the likelihood of successful community discharge from skilled nursing facilities.
This retrospective cohort study examined the association of patient and direct-care staff beliefs about patients’ probabilities of a successful discharge to the community after a skilled nursing facility (SNF) stay. 100% Medicare inpatient claims and Minimum Data Set resident assessment data was used to identify a cohort of 526,432 Medicare beneficiaries aged 66 or older who were discharged to an SNF after hospitalization for stroke, hip fracture, or traumatic brain injury. A successful discharge was considered to be patients who were discharged alive 90 or more days after hospitalization and remained in the community for at least 30 days without dying or health care facility readmission. A positive patient attitude was found to increase probability of successful discharge without or without positive staff beliefs. However, the difference in successful discharge probability between patients with positive and negative beliefs was larger when staff had positive beliefs.
AHRQ-funded; HS000011.
Citation:
Evans E, Kosar CM, Thomas KS .
Positive beliefs and the likelihood of successful community discharge from skilled nursing facilities.
Arch Phys Med Rehabil 2021 Mar;102(3):480-87. doi: 10.1016/j.apmr.2020.09.375..
Keywords:
Elderly, Rehabilitation, Nursing Homes, Patient-Centered Healthcare
Dean JM, Hreha K, Hong I
Post-acute care use patterns among hospital service areas by older adults in the United States: a cross-sectional study.
This study examined post-stroke acute care patterns across Hospital Service Areas among a national stroke cohort of Medicare beneficiaries to determine drivers of variation in post-acute care service utilization. Data was extracted from 2013 to 2014 (174,498 total records across 3232 Hospital Service Areas). Patients’ residence ZIP codes were linked to the facility ZIP code where care was received. Patients were considered a “traveler” if they did not live in the Hospital Service Area where they received care. Only 23.5% of all patients received care in skilled nursing-only Hospital Service Areas although 73.4% of all Hospital Service Areas were skilled nursing-only. Thirty-five percent of all patients traveled to a different Hospital Service Area from their residence. Patients living in skilled nursing-only Hospital Service Areas had more than 5 times the odds of traveling compared to those living in Hospital Service Areas with skilled nursing, inpatient rehabilitation, and long-term care hospital services.
AHRQ-funded; HS026133; HS024711.
Citation:
Dean JM, Hreha K, Hong I .
Post-acute care use patterns among hospital service areas by older adults in the United States: a cross-sectional study.
BMC Health Serv Res 2021 Feb 25;21(1):176. doi: 10.1186/s12913-021-06159-z..
Keywords:
Elderly, Hospitals, Access to Care, Stroke, Cardiovascular Conditions, Healthcare Utilization, Rehabilitation, Nursing Homes
Thompson MP, Yaser JM, Hou H
Determinants of hospital variation in cardiac rehabilitation enrollment during coronary artery disease episodes of care.
Cardiac rehabilitation (CR) is associated with improved outcomes for patients with coronary artery disease (CAD). However, CR enrollment remains low and there is a dearth of real-world data on hospital-level variation in CR enrollment. In this study, the investigators sought to explore determinants of hospital variability in CR enrollment during CAD episodes of care: medical management of acute myocardial infarction (AMI-MM), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG).
AHRQ-funded; HS026003.
Citation:
Thompson MP, Yaser JM, Hou H .
Determinants of hospital variation in cardiac rehabilitation enrollment during coronary artery disease episodes of care.
Circ Cardiovasc Qual Outcomes 2021 Feb;14(2):e007144. doi: 10.1161/circoutcomes.120.007144..
Keywords:
Heart Disease and Health, Cardiovascular Conditions, Rehabilitation, Outcomes, Patient-Centered Outcomes Research, Hospitals
Roberts AC, Rafferty MR, Wu SS
Patterns and predictors of referrals to allied health services for individuals with Parkinson's disease: a Parkinson's foundation (PF) QII study.
Rehabilitation therapies are critical for optimizing quality-of-life and daily functions for individuals living with Parkinson's disease (PD). Thus, understanding the patterns of and under what conditions physicians make rehabilitation referrals is important for optimizing care. In this study, the investigators analyzed data from 5020 participants (4 countries) collected from 1/3/2016 to 4/20/2018 as part of the Parkinson's Foundation Quality Improvement Initiative (PF QII).
AHRQ-funded; HS025077.
Citation:
Roberts AC, Rafferty MR, Wu SS .
Patterns and predictors of referrals to allied health services for individuals with Parkinson's disease: a Parkinson's foundation (PF) QII study.
Parkinsonism Relat Disord 2021 Feb;83:115-22. doi: 10.1016/j.parkreldis.2020.11.024..
Keywords:
Neurological Disorders, Rehabilitation
Fritz JM, Lane E, McFadden M
Physical therapy referral from primary care for acute back pain with sciatica : a randomized controlled trial.
This study examined whether early physical therapy (EPT) use in sciatica patients of less than 90 days duration reduces disability compared to usual care (UC) alone. A cohort of 220 adult sciatica patients ages 18 to 60 at two healthcare systems in Salt Lake City, Utah were randomly assigned to the control or EPT. Half (110) were given EPT, 1 education session, and then referred to 4 weeks of physical therapy including exercise and manual therapy. The other 110 were provided usual care. Outcomes were measured using the Oswestry Disability Index (OSW) after 6 months. Secondary outcomes were pain intensity, patient-reported treatment success, health care use or missed workdays. The EPT group were more likely to self-report less back pain after 5 weeks as well as treatment success after 1 year than the UC care group. There were no significant differences in health care use or missed workdays with the 2 groups.
AHRQ-funded; HS022641.
Citation:
Fritz JM, Lane E, McFadden M .
Physical therapy referral from primary care for acute back pain with sciatica : a randomized controlled trial.
Ann Intern Med 2021 Jan;174(1):8-17. doi: 10.7326/m20-4187..
Keywords:
Back Health and Pain, Neurological Disorders, Pain, Rehabilitation, Primary Care, Outcomes, Patient-Centered Outcomes Research, Comparative Effectiveness, Evidence-Based Practice
Bell KM, Onyeukwu C, Smith CN
A portable system for remote rehabilitation following a total knee replacement: a pilot randomized controlled clinical study.
The authors have developed and previously validated the accuracy of a remote (wearable) rehabilitation monitoring platform (interACTION). The present study's objective was to assess the feasibility of utilizing interACTION for the remote management of rehabilitation after total knee replacement (TKR) and to determine a preliminary estimate of the effects of the interACTION system on the value of rehabilitation. Findings showed that all patients and physical therapists in the interACTION Group indicated that they would use the system again in the future. Therefore, the next steps are to address the concerns identified in this pilot study and to expand the platform to include behavioral change strategies prior to conducting a full-scale randomized controlled trial.
Citation:
Bell KM, Onyeukwu C, Smith CN .
A portable system for remote rehabilitation following a total knee replacement: a pilot randomized controlled clinical study.
Sensors 2020 Oct 27;20(21). doi: 10.3390/s20216118..
Keywords:
Orthopedics, Rehabilitation, Health Information Technology (HIT)
Askew RL, Capo-Lugo CE, Naidech A
Differential effects of time to initiation of therapy on disability and quality of life in patients with mild and moderate to severe ischemic stroke.
This study’s objective was to assess the effect of time to therapy consult and treatment on health-related quality of life (HRQoL) and disability after ischemic stroke. This prospective cohort study was conducted at a comprehensive stroke center in a large metropolitan city. A modified Rankin Scale (mRS) and Barthel Index (BI) were used to assess disability status. HRQoL was assessed using the Quality of Life in Neurological Disorders measures of executive function, general cognitive concerns, upper extremity dexterity and lower extremity mobility. A longer time to therapy treatment led to increased disability and lower mobility T scores. It also had an effect on poststroke disability and HRQoL up to 1 month after ischemic stroke and TIA.
AHRQ-funded; HS024366; HS023437; HS000078.
Citation:
Askew RL, Capo-Lugo CE, Naidech A .
Differential effects of time to initiation of therapy on disability and quality of life in patients with mild and moderate to severe ischemic stroke.
Arch Phys Med Rehabil 2020 Sep;101(9):1515-22.e1. doi: 10.1016/j.apmr.2020.05.005..
Keywords:
Stroke, Cardiovascular Conditions, Quality of Life, Rehabilitation
Hsieh CJ, DeJong G, Vita M
Effect of outpatient rehabilitation on functional mobility after single total knee arthroplasty: a randomized clinical trial.
Researchers compared post-total knee arthroplasty (TKA) functional mobility outcomes among 3 newly-developed physical therapy protocols with a standard-of-care post-TKA rehabilitation protocol. They found no statistically or clinically significant differences in outcomes across the 4 study arms (control, treadmill, neuromuscular stimulation device, and combination intervention). As outcomes were similar among arms, they recommended that clinicians instead consider relative cost in tailoring TKA rehabilitation.
AHRQ-authored.
Citation:
Hsieh CJ, DeJong G, Vita M .
Effect of outpatient rehabilitation on functional mobility after single total knee arthroplasty: a randomized clinical trial.
JAMA Netw Open 2020 Sep;3(9):e2016571. doi: 10.1001/jamanetworkopen.2020.16571..
Keywords:
Rehabilitation, Orthopedics, Surgery, Outcomes, Evidence-Based Practice
Khan U, Stoff L, Yahuaca JD
Evaluation of an interdisciplinary screening program for people with Parkinson disease and movement disorders.
Researchers described the characteristics of people with Parkinson disease and movement disorders referred by neurologist to a physiatrist-led interdisciplinary rehabilitation screening program. They found that the interdisciplinary rehabilitation screening program was sustained with increased numbers of referrals over time, occurring earlier in the disease in more recent years. Further, key strategies used to sustain the program over time included development of a unique referral order set for the neurologists, implementation of a comprehensive screen tool in the rehabilitation hospital electronic health records, and centralized communication through social workers at both facilities.
AHRQ-funded; HS025077.
Citation:
Khan U, Stoff L, Yahuaca JD .
Evaluation of an interdisciplinary screening program for people with Parkinson disease and movement disorders.
Arch Rehabil Res Clin Transl 2020 Sep;2(3):100067. doi: 10.1016/j.arrct.2020.100067..
Keywords:
Neurological Disorders, Rehabilitation, Screening
Rundell SD, Resnik L, Heagerty PJ
Performance of the Functional Comorbidity Index (FCI) in prognostic models for risk adjustment in patients with back pain.
The Functional Comorbidity Index (FCI) is a comorbidity measure associated with physical function and may contribute to risk adjustment models in rehabilitation settings, but an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) of the FCI has not been tested in outpatient settings. The purpose of this cohort study was to examine the ability of an ICD-9-CM- based FCI to predict function, health-related quality of life, and overall health care use.
AHRQ-funded; HS01922201; HS022972.
Citation:
Rundell SD, Resnik L, Heagerty PJ .
Performance of the Functional Comorbidity Index (FCI) in prognostic models for risk adjustment in patients with back pain.
Pm r 2020 Sep;12(9):891-98. doi: 10.1002/pmrj.12315..
Keywords:
Back Health and Pain, Pain, Chronic Conditions, Quality of Life, Rehabilitation
Keeney T
Physical therapy in the COVID-19 pandemic: forging a paradigm shift for rehabilitation in acute care.
This point-of-view article discusses the importance of physical therapy for COVID-19 survivors in home and community-based settings as well as in post-acute care facilities, concluding that it is necessary to react to new and difficult circumstances with growth and self-advocacy in order to forge a future characterized by intensive skilled rehabilitation services in the inpatient setting, simultaneously benefiting the health care systems and the patient populations.
AHRQ-funded; HS000011.
Citation:
Keeney T .
Physical therapy in the COVID-19 pandemic: forging a paradigm shift for rehabilitation in acute care.
Phys Ther 2020 Aug 12;100(8):1265-67. doi: 10.1093/ptj/pzaa097..
Keywords:
Rehabilitation, COVID-19, Transitions of Care, Home Healthcare, Healthcare Delivery
Capo-Lugo CE, Askew RL, Muldoon K
Longer time before acute rehabilitation therapy worsens disability after intracerebral hemorrhage.
This study examines the association of time to initiation of acute rehabilitation therapy to increases in disability after intracerebral hemorrhage (ICH), and identifies predictors of time to initiation of rehabilitation therapy. Retrospective data analysis was conducted using ICH patients from a large comprehensive stroke center in a metropolitan area. Disability was assessed using a modified Rankin Scale (mRS) with poor outcome defined as mRS 4-6. There was a median time of 3 days from hospital admission and the first consult by any rehabilitation therapy specialist. Each additional day between admission and initiation of acute rehabilitation therapy was associated with odds of poor outcome at 30 days and at 90 days. Predictors of later initiation of acute rehabilitation therapy included heavy drinking (>5 drinks per day), premorbid mRS<4, presence of pulmonary embolism and longer length of stay in the intensive care unit.
AHRQ-funded; HS024366; HS023437; HS000078.
Citation:
Capo-Lugo CE, Askew RL, Muldoon K .
Longer time before acute rehabilitation therapy worsens disability after intracerebral hemorrhage.
Arch Phys Med Rehabil 2020 May;101(5):870-76. doi: 10.1016/j.apmr.2019.11.006..
Keywords:
Rehabilitation, Disabilities, Stroke, Cardiovascular Conditions, Outcomes, Patient-Centered Outcomes Research
Kittelson AJ, Hoogeboom TJ, Schenkman M
Person-centered care and physical therapy: a "people-like-me" approach.
In this perspective paper, the authors propose developing "people-like-me" reference charts, generated with historical outcomes data, to provide real-time information on an individual's status relative to similar people, using as an example people rehabilitating after total knee arthroplasty. The authors propose this framework as a practical mechanism to advance person-centered decisions in physical therapy according to the ideals of evidence-based practice.
AHRQ-funded; HS024316; HS025692.
Citation:
Kittelson AJ, Hoogeboom TJ, Schenkman M .
Person-centered care and physical therapy: a "people-like-me" approach.
Phys Ther 2020 Jan 23;100(1):99-106. doi: 10.1093/ptj/pzz139..
Keywords:
Patient-Centered Healthcare, Rehabilitation, Orthopedics, Evidence-Based Practice, Patient-Centered Outcomes Research, Surgery
Weerahandi H, Bao H, Herrin J
Home health care after skilled nursing facility discharge following heart failure hospitalization.
Heart failure (HF) readmission rates have plateaued despite scrutiny of hospital discharge practices. Many HF patients are discharged to skilled nursing facility (SNF) after hospitalization before returning home. Home healthcare (HHC) services received during the additional transition from SNF to home may affect readmission risk. In this study, the investigators examined whether receipt of HHC affects readmission risk during the transition from SNF to home following HF hospitalization.
AHRQ-funded; HS022882.
Citation:
Weerahandi H, Bao H, Herrin J .
Home health care after skilled nursing facility discharge following heart failure hospitalization.
J Am Geriatr Soc 2020 Jan;68(1):96-102. doi: 10.1111/jgs.16179..
Keywords:
Home Healthcare, Nursing Homes, Heart Disease and Health, Cardiovascular Conditions, Hospitalization, Hospital Readmissions, Transitions of Care, Rehabilitation, Value
Hay CC, Graham JE, Pappadis MR
The impact of one's sex and social living situation on rehabilitation outcomes after a stroke.
The goal of this retrospective observational study was to investigate sex differences and the impact of social living situation on individual functional independence measure outcomes after stroke rehabilitation. Subjects were Medicare fee-for-service beneficiaries discharged from inpatient rehabilitation facilities after a stroke. Results showed that when sociodemographic and clinical factors were controlled, females were more likely to discharge from inpatient rehabilitation at a supervision level or better for most functional independence measure items. Individuals who lived alone before their stroke had higher odds of discharging at a supervision level or better.
AHRQ-funded; HS022134.
Citation:
Hay CC, Graham JE, Pappadis MR .
The impact of one's sex and social living situation on rehabilitation outcomes after a stroke.
Am J Phys Med Rehabil 2020 Jan;99(1):48-55. doi: 10.1097/phm.0000000000001276..
Keywords:
Stroke, Rehabilitation, Elderly, Patient-Centered Outcomes Research, Sex Factors, Cardiovascular Conditions, Outcomes
