Patients' functional independence may predict readmissions

Inpatients' ability to perform everyday tasks like walking, eating and dressing themselves could help determine their likelihood of readmission within 30 days, according to a new study published in the Journal of Hospital Medicine.

Rehab facilities already administer the test, known as the Functional Independence Measure (FIM), to patients within 72 hours of admission. "The Functional Independence Measure score is a direct reflection of a patient's ability to heal," lead author Erik Hoyer, M.D., an assistant professor in the Department of Physical Medicine and Rehabilitation at the Johns Hopkins University School of Medicine, said in a statement. "When a person cannot move his or her legs or use the bathroom independently, for example, it's telling us something about the body's physiologic reserve, its overall ability to be resilient to disease."

Hoyer and his team conducted a retrospective analysis of 9,405 consecutive acute care hospital patients admitted to an inpatient rehab facility between July 1, 2006 and December 31, 2012. Each patient was assessed as low, middle or high functional status based on his or her FIM scores. The scores were "significantly associated" with readmission to an acute care hospital within 30 days of discharge, according to the study, and readmissions were highest among patients with FIM scores classified as "low."  These patients were two to three times more likely to be readmitted than those assessed as "high."

Researchers found that of the three categories for rehab admissions--medical, neurological and orthopedic--patients in the medical category were most likely to face readmission, according to the Hopkins statement. "Reducing functional status decline during acute care hospitalization may be an important strategy to lower readmissions," the study abstract states.

A February study found that more than 10 percent of Medicare patients are readmitted within 30 days of discharge from inpatient rehabilitation facilities, FierceHealthcare previously reported.

To learn more:
- here's the study abstract
- read the Hopkins statement

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