Positive Beliefs and the Likelihood of Successful Community Discharge From Skilled Nursing Facilities.
Brain injuries
Goals
Hip fractures
Medicare
Patient-centered care
Rehabilitation
Rehabilitation research
Skilled nursing facilities
Stroke
United States
Journal
Archives of physical medicine and rehabilitation
ISSN: 1532-821X
Titre abrégé: Arch Phys Med Rehabil
Pays: United States
ID NLM: 2985158R
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
received:
29
01
2020
revised:
07
08
2020
accepted:
01
09
2020
pubmed:
30
9
2020
medline:
16
3
2021
entrez:
29
9
2020
Statut:
ppublish
Résumé
To examine the association of patient and direct-care staff beliefs about patients' capability to increase independence with activities of daily living (ADL) and the probability of successful discharge to the community after a skilled nursing facility (SNF) stay. Retrospective cohort study of SNF patients using 100% Medicare inpatient claims and Minimum Data Set resident assessment data. Linear probability models were used to estimate the probability of successful discharge based on patient and staff beliefs about the patient's ability to improve in function, as well as patient and staff beliefs together. Estimates were adjusted for demographics, health status, functional characteristics, and SNF fixed effects. Fee-for-service Medicare beneficiaries (N=526,432) aged 66 years or older who were discharged to an SNF after hospitalization for stroke, hip fracture, or traumatic brain injury. Not applicable. Successful community discharge (discharged alive within 90d of SNF admission and remaining in the community for ≥30d without dying or health care facility readmission). Patients with positive beliefs about their capability to increase independence with ADLs had a higher adjusted probability of successful discharge than patients with negative beliefs (positive, 63.8%; negative, 57.8%; difference, 6.0%, 95% confidence interval [CI], 5.4-6.6). This remained true regardless of staff beliefs, but the difference in successful discharge probability between patients with positive and negative beliefs was larger when staff had positive beliefs. Conversely, the association between staff beliefs and successful discharge varied based on patient beliefs. If patients had positive beliefs, the difference in the probability of successful discharge between positive and negative staff beliefs was 2.5% (95% CI, 1.0-4.0). If patients had negative beliefs, the difference between positive and negative staff beliefs was -4.6% (95% CI, -6.0 to -3.2). Patients' beliefs have a significant association with the probability of successful discharge. Understanding patients' beliefs is critical to appropriate goal-setting, discharge planning, and quality SNF care.
Identifiants
pubmed: 32991871
pii: S0003-9993(20)30960-6
doi: 10.1016/j.apmr.2020.09.375
pmc: PMC8996741
mid: NIHMS1792143
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
480-487Subventions
Organisme : HSRD VA
ID : IK2 HX001775
Pays : United States
Organisme : NIA NIH HHS
ID : R21 AG059120
Pays : United States
Organisme : NIA NIH HHS
ID : P01 AG027296
Pays : United States
Organisme : AHRQ HHS
ID : T32 HS000011
Pays : United States
Organisme : HSRD VA
ID : CDA 14-422
Pays : United States
Informations de copyright
Copyright © 2020. Published by Elsevier Inc.
Références
Health Serv Res. 2009 Aug;44(4):1188-210
pubmed: 19490159
Psychosom Med. 2008 May;70(4):404-9
pubmed: 18434490
Am J Phys Med Rehabil. 2017 Jul;96(7):487-505
pubmed: 28628537
Fed Regist. 2018 Aug 08;83(153):39162-290
pubmed: 30091551
J Am Med Dir Assoc. 2018 Apr;19(4):348-354.e4
pubmed: 29371127
J Am Geriatr Soc. 2000 Mar;48(3):283-8
pubmed: 10733054
Disabil Rehabil. 2018 Jun;40(12):1401-1409
pubmed: 28320217
J Neurotrauma. 2013 Dec 15;30(24):2001-13
pubmed: 23962046
Clin Rehabil. 2011 Jun;25(6):501-14
pubmed: 21441308
J Am Geriatr Soc. 2004 Feb;52(2):284-9
pubmed: 14728642
J Gen Intern Med. 2001 Sep;16(9):606-13
pubmed: 11556941
Clin Rehabil. 2011 May;25(5):468-82
pubmed: 21131335
Am J Phys Med Rehabil. 2002 Oct;81(10):726-30
pubmed: 12362111
J Rehabil Med. 2011 Jan;43(2):156-61
pubmed: 21234516
Clin Interv Aging. 2016 Sep 28;11:1351-1363
pubmed: 27729778
J Allied Health. 2010 Winter;39(4):e149-54
pubmed: 21184017
J Aging Health. 2011 Feb;23(1):112-34
pubmed: 20921327
Clin Rehabil. 2009 Apr;23(4):291-5
pubmed: 19293289
Appl Nurs Res. 2018 Feb;39:189-194
pubmed: 29422157
J Adv Nurs. 2011 Sep;67(9):1876-94
pubmed: 21645040
Int J Aging Hum Dev. 1992;34(4):339-50
pubmed: 1607220
Disabil Rehabil. 2009;31(11):880-6
pubmed: 19037772
J Pain Res. 2019 Jan 15;12:353-362
pubmed: 30697062
J Health Serv Res Policy. 2000 Jul;5(3):133-9
pubmed: 11183623
Rehabil Nurs. 2002 Jul-Aug;27(4):152-9
pubmed: 12116528
Soc Sci Med. 2004 Nov;59(9):1867-78
pubmed: 15312921
Med Care. 2017 Sep;55(9):e68-e72
pubmed: 25763665
Disabil Rehabil. 2014;36(12):1020-6
pubmed: 23962191
J Am Geriatr Soc. 2017 Aug;65(8):1748-1755
pubmed: 28369687
Brain Inj. 2003 Jan;17(1):55-71
pubmed: 12519648
Fed Regist. ;82(149):36530-634
pubmed: 28805359
Clin Rehabil. 2005 Jan;19(1):97-108
pubmed: 15704514
Arch Phys Med Rehabil. 1999 Apr;80(4):448-52
pubmed: 10206609
Int Orthop. 2012 Aug;36(8):1709-14
pubmed: 22437265
Fed Regist. 2016 Aug 5;81(151):51969-2053
pubmed: 27529900
Patient Educ Couns. 2006 Oct;63(1-2):145-51
pubmed: 16406471
J Gerontol A Biol Sci Med Sci. 1999 Nov;54(11):M546-53
pubmed: 10619316
Soc Sci Med. 2000 Oct;51(7):1087-110
pubmed: 11005395
Clin Rehabil. 2019 Jan;33(1):128-140
pubmed: 30103621
J Neurotrauma. 2015 Feb 15;32(4):280-6
pubmed: 25203001
J Rheumatol. 2002 Jun;29(6):1273-9
pubmed: 12064846
J Comorb. 2016 Nov 14;6(2):120-126
pubmed: 29090183
J Adv Nurs. 2014 Apr;70(4):714-28
pubmed: 24001198
BMC Geriatr. 2013 Dec 13;13:136
pubmed: 24330470
Physiother Theory Pract. 2018 Jul;34(7):495-504
pubmed: 29308969
Med Care Res Rev. 2013 Dec;70(6):567-96
pubmed: 23894060
Med Care. 2015 Oct;53(10):879-87
pubmed: 26340664
Arch Phys Med Rehabil. 2001 Dec;82(12 Suppl 2):S2-8
pubmed: 11805913
J Am Med Dir Assoc. 2015 Jun 1;16(6):470-4
pubmed: 25659622
Am J Occup Ther. 1998 Sep;52(8):629-37
pubmed: 9739396
Disabil Rehabil. 2010;32(2):159-72
pubmed: 19562579
J Clin Nurs. 2009 Sep;18(18):2539-46
pubmed: 19374695
BMC Health Serv Res. 2013 May 24;13:190
pubmed: 23705824
Age Ageing. 2010 Jan;39(1):31-8
pubmed: 19934075
Stroke. 2002 Feb;33(2):444-8
pubmed: 11823650
Health Serv Res. 2011 Feb;46(1 Pt 1):120-37
pubmed: 21029090
Clin Rehabil. 2016 May;30(5):508-19
pubmed: 25952590
J Pain Symptom Manage. 2018 Mar;55(3):930-937
pubmed: 29097273
Med Care. 2017 Jul;55(7):698-705
pubmed: 28498196
J Am Geriatr Soc. 2006 Jul;54(7):1074-81
pubmed: 16866678
N Engl J Med. 1995 May 18;332(20):1338-44
pubmed: 7715644
N Engl J Med. 2012 Mar 1;366(9):777-9
pubmed: 22375966