Use of AM-PAC “6 Click” Scores to Predict Discharge Location Post-hospitalization in Adults With Cardiovascular Disease: A Retrospective Cohort Study

Abstract

Purpose: Scores on the Activity Measure for Post-Acute Care (AMPAC) 6-Clicks are used in the hospital setting as functional measures to guide care and discharge recommendations. However, limited evidence exists regarding the accuracy of AMPAC 6-Clicks in predicting discharge location for those with cardiovascular disease (CVD). The purpose of this study was to determine the accuracy of AM-PAC 6-Clicks scores to predict discharge to home/self-care from an acute care hospital in adults with CVD. Methods: A retrospective review of 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. Logistic regression analyses were performed to determine if 6-Clicks scores could predict discharge to home/self-care while controlling for age, insurance type, and length of stay. Receiver operating characteristic curves were created to determine the 6-Clicks scores with the best sensitivity/specificity to determine discharge to home/self-care. Results: Logistic regression models indicated that the basic mobility score at discharge from physical therapy services accounted for 71% of the variance in predicting discharge to home/self-care after controlling for covariates. The best 6-Clicks non-converted cutoff value for accuracy of discharge to home/self-care was 20.50 for daily activity and 18.5 for basic mobility completed at discharge. Conclusions: Basic mobility scores at discharge are significant predictors of discharge to home/self-care in older adults with CVD. Further inpatient rehabilitation services should be considered for patients who score less than 18.5 (converted = 44.5) on the basic mobility or 20.50 (converted = 43.15) on the daily activity measures.