Predictors of Hospital Readmissions for People with Chronic Conditions

Abstract

Background: Hospital readmissions remain prominent in health care. Functional, cognitive, and environmental factors predict hospital readmissions but may not be thoroughly measured or addressed prior to discharge. Method: In this cross-sectional study, people hospitalized with chronic conditions completed measures of self-care function, functional cognition, occupational competence, and environmental impact. They also participated in a phone call or medical records review to identify hospital readmissions within 30 days of discharge. In a group session, occupational therapists who work in acute care completed acceptability, appropriateness, and feasibility measures for the standardized assessments administered to hospital participants. Results: Occupational competence and functional cognition were significant predictors of hospital readmissions. Therapists rated the Activity Measure of Post-Acute Care (AM-PAC) as the most acceptable, appropriate, and feasible measure for acute care. Conclusions: Occupational competence and functional cognition are predictors of hospital readmissions in people with chronic conditions. Occupational therapists in acute care should consider supplementing current evaluation practices with standardized measures of functional cognition and occupational competence to identify client needs objectively and initiate post-acute referrals that help clients discharge home successfully. Standardized measures, such as the AM-PAC may be feasible in acute care. Further research on the efficacy of standardized measures in this setting is needed.