scholarly journals Rehabilitation in adult post-COVID-19 patients in post-acute care with Therapeutic Exercise

2021 ◽  
pp. 1-4
Author(s):  
C. Udina ◽  
J. Ars ◽  
A. Morandi ◽  
J. Vilaró ◽  
C. Cáceres ◽  
...  
Keyword(s):  
Acute Care ◽  
Physical Performance ◽  
Exercise Intervention ◽  
Balance Training ◽  
Care Facility ◽  
Therapeutic Exercise ◽  
Training Outcomes ◽  
Single Leg Stance ◽  
Post Impact ◽  
Post Acute Care

COVID-19 patients may experience disability related to Intensive Care Unit (ICU) admission or due to immobilization. We assessed pre-post impact on physical performance of multi-component therapeutic exercise for post-COVID-19 rehabilitation in a post-acute care facility. A 30-minute daily multicomponent therapeutic exercise intervention combined resistance, endurance and balance training. Outcomes: Short Physical Performance Battery; Barthel Index, ability to walk unassisted and single leg stance. Clinical, functional and cognitive variables were collected. We included 33 patients (66.2±12.8 years). All outcomes improved significantly in the global sample (p<0.01). Post-ICU patients, who were younger than No ICU ones, experienced greater improvement in SPPB (4.4±2.1 vs 2.5±1.7, p<0.01) and gait speed (0.4±0.2 vs 0.2±0.1 m/sec, p<0.01). In conclusion, adults surviving COVID-19 improved their functional status, including those who required ICU stay. Our results emphasize the need to establish innovative rehabilitative strategies to reduce the negative functional outcomes of COVID-19.

scholarly journals Hospital to Post-Acute Care Facility Transfers: Identifying Targets for Information Exchange Quality Improvement

2017 ◽  
Vol 18 (1) ◽  
pp. 70-73 ◽  
Author(s):  
Christine D. Jones ◽  
Ethan Cumbler ◽  
Benjamin Honigman ◽  
Robert E. Burke ◽  
Rebecca S. Boxer ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Acute Care ◽  
Information Exchange ◽  
Care Facility ◽  
Acute Care Facility ◽  
Post Acute Care

111 Misaligned Incentives for Lumbar Spine Surgery in the Bundled Payment for Care Initiative

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 223-223
Author(s):  
Joseph E Tanenbaum ◽  
Dominic Pelle ◽  
Edward C Benzel ◽  
Michael P Steinmetz ◽  
Thomas Mroz
Keyword(s):  
Acute Care ◽  
Lumbar Fusion ◽  
Hospital Costs ◽  
Care Facility ◽  
Thoracolumbar Fracture ◽  
Acute Care Facility ◽  
Patient Demographics ◽  
Episode Of Care ◽  
Hospital Characteristics ◽  
Post Acute Care

Abstract INTRODUCTION Under the Bundled Payments for Care Initiative (BPCI), Medicare reimburses for lumbar fusion without adjusting for the patient's underlying pathology. We compared the hospital resource use of two lumbar fusion cohorts that BPCI groups into the same payment bundle: patients with spondylolisthesis and patients with thoracolumbar fracture. METHODS With BPCI, hospitals are reimbursed for a lumbar fusion episode of care if patients are assigned diagnosis related group (DRG) 459 or 460. Vertebroplasty and kyphoplasty use different DRGs. National Inpatient Sample data from 2013 were queried to identify all patients that underwent lumbar fusion to treat a primary diagnosis of thoracolumbar fracture or spondylolisthesis and that were assigned DRG 459 or 460. Multivariable linear and logistic regression were used to compare length of hospital stay (LOS), direct hospital costs, and odds of discharge to a post-acute care facility for thoracolumbar fracture patients and spondylolisthesis patients. All models adjusted for patient demographics, 29 comorbidities, and hospital characteristics. The complex survey design of the NIS was taken into account in all models. RESULTS >After adjusting for patient demographics, insurance status, hospital characteristics, and 29 comorbidities, spondylolisthesis patients had a mean LOS that was 36% shorter (95% CI 26% - 44%, P< 0.0001), a mean cost that was 13% less (95% CI 3.7% - 21%, P< 0.0001), and had 3.6 times greater odds of being discharged home (95% CI 2.5 5.4, P< 0.0001) than thoracolumbar fracture patients. CONCLUSION Under the proposed DRG-based BPCI, hospitals would be reimbursed the same amount for lumbar fusion regardless of whether a patient had spondylolisthesis or thoracolumbar fracture. However, compared with fusion for spondylolisthesis, fusion for thoracolumbar fracture was associated with longer LOS, greater direct hospital costs, and increased likelihood of being discharged to a post-acute care facility. Our findings suggest that the BPCI episode of care for lumbar fusion dis-incentivizes treating trauma patients.

scholarly journals Marriage Status Predicts Hospital Outcomes Following Orthopedic Trauma

2020 ◽  
Vol 11 ◽  
pp. 215145931989864
Author(s):  
Sanjit R. Konda ◽  
Leah J. Gonzalez ◽  
Joseph R. Johnson ◽  
Scott Friedlander ◽  
Kenneth A. Egol
Keyword(s):  
Hospital Stay ◽  
Marital Status ◽  
Acute Care ◽  
Multinomial Logistic Regression ◽  
Academic Medical Center ◽  
Care Facility ◽  
Unplanned Readmission ◽  
Term Care ◽  
Discharge Disposition ◽  
Post Acute Care

Introduction: Rising costs of post-acute care facilities for both the patient and payers make discharge home after hospital stay, with or without home help, a favorable alternative for all parties. Our objectives were to assess the effect of marital status, a large source of social support for many, on disposition following hospital stay. Methods: Patients were prospectively entered into an institutional review board-approved, trauma database at a large, academic medical center. Patients aged 55 years or older with any fracture injury between 2014 and 2017 were included. Retrospectively, their relationship status was recorded through review of patient records. A status of “married” was separated from those with a status self-reported as “single,” “divorced,” or “widowed.” Multinomial logistic regression was used to assess whether discharge location differs by marital status while controlling for demographics and injury characteristics. Results: Of 1931 patients, 8.3% were divorced, 29.9% were single, 20.0% were widowed, and 41.8% were married. There was a significant correlation between discharge disposition and marital status. Single patients had 1.71 times, and widowed patients had 1.80 times, the odds of being discharged to a nursing home, long-term care facility, or skilled nursing facility compared to married patients after controlling for age, gender, Score for Trauma Triage in the Geriatric and Middle-Aged score, and insurance type. Additionally, single and widowed patients experienced 1.36 and 1.30 times longer length of hospital stay than their married counterparts, respectively. Discussion: Patients who are identified as “single” or “widowed” should have early social work intervention to establish clear discharge expectations. Early intervention in this way would allow time for contact with close, living relatives or friends who may be able to provide sufficient support so that patients can return home. Increasing home discharge rates for these patients would reduce lengths of hospital stay and reduce post-acute care costs for both patient and payers without materially altering unplanned readmission rates.

scholarly journals A predictive score to identify hospitalized patients' risk of discharge to a post-acute care facility

2008 ◽  
Vol 8 (1) ◽  
Author(s):  
Martine Louis Simonet ◽  
Michel P Kossovsky ◽  
Pierre Chopard ◽  
Philippe Sigaud ◽  
Thomas V Perneger ◽  
...  
Keyword(s):  
Acute Care ◽  
Care Facility ◽  
Hospitalized Patients ◽  
Predictive Score ◽  
Acute Care Facility ◽  
Post Acute Care

Service Use and Barriers with Post-Acute-Care Rehabilitation Following Acquired Brain Injury: Family Caregiver Perspectives

2016 ◽  
Vol 22 (2) ◽  
pp. 128-134 ◽  
Author(s):  
Charles Edmund Degeneffe ◽  
Richard Green ◽  
Clair Jones
Keyword(s):  
Brain Injury ◽  
Acute Care ◽  
Service Use ◽  
Care Facility ◽  
Acquired Brain Injury ◽  
The United States ◽  
Post Discharge ◽  
Service Areas ◽  
Barriers To Use ◽  
Post Acute Care

The study aimed to understand the use and barriers to use of post-acute-care services by persons with acquired brain injury (ABI). A total of 21 primary family caregivers of persons recently discharged from an ABI acute-care facility in a large southwestern city in the United States participated. Service use in 14 domains appeared consistent with post-discharge needs. In five service areas, participants were not aware the service was available. Professionals in acute ABI rehabilitation units need to be fully aware of the range of available potential supports and diligent in informing injured persons and their families about available post-discharge services.

scholarly journals Post-acute Care for Children and Youth in Texas, 2011-2014

2017 ◽  
Vol 11 ◽  
pp. 117955651771144 ◽  
Author(s):  
Charles D Phillips ◽  
Chau Truong ◽  
Hye-Chung Kum ◽  
Obioma Nwaiwu ◽  
Robert Ohsfeldt
Keyword(s):  
Health Care ◽  
Health Services ◽  
Acute Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Home Health ◽  
Children And Youth ◽  
Home Health Services ◽  
Low Prevalence ◽  
Post Acute Care

Little is known about services provided to children and youth (C/Y) discharged from an acute care facility. Recent research has provided a foundation for efforts to supplement or complement that early work. This research investigates post-acute care (PAC) in Texas. It focuses on what differentiates those discharges that receive PAC from those that do not and on what differentiates those C/Y who receive PAC in a health care facility from those who receive home health services. The results show that only 6.4% of discharges involving C/Y receive PAC and that many factors affected the 2 issues under investigation quite differently. These results clearly demonstrate the low prevalence of PAC use for C/Y and the clear preference of using PAC home health in this population.

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