Determinants of acute care discharge in adults with chronic obstructive pulmonary disease

Abstract

ABSTRACT The purpose of this study was to identify if AM-PAC “6-clicks” could predict discharge from an acute hospitalization to home with home health services or inpatient rehabilitation as compared to discharge to self-care at home in adults with COPD. A retrospective review of electronic medical record data comprised of AM-PAC “6-clicks” basic mobility or daily activity scores at physical or occupational therapy evaluation and discharge was completed. Multinomial logistic regression analyses were performed to determine if AM-PAC “6-clicks” scores could predict discharge to inpatient rehabilitation or home health services with the reference of home with self-care while controlling for age, insurance type, and gender. Receiver operating characteristic curves were created to determine the AM-PAC “6-clicks” scores with the best sensitivity/specificity to determine discharge to home with/without further rehab services. Logistic regression models indicated that basic mobility scores at discharge had the best sensitivity and specificity for discharge home with or without home health-care services. Daily activity scores at either evaluation or discharge are similar in their contribution to discharge status. Conclusions In adults with COPD basic mobility scores on the AM-PAC “6-clicks” measure completed at discharge had the best sensitivity and specificity for predicting discharge to home and need for rehab services.