title: Health care transitions and the aging population: a framework for measuring the value of rapid rehabilitation.
abstract: A study was undertaken to establish a framework to measure the value of rapid rehabilitation and identify indicators to quantify effective outcomes and efficient processes as health care services are delivered to the aging population across providers, services, and settings. The rapid rehabilitation protocol serving as intervention in this research provides patients (≥65 years old) the option to transition from the acute-care hospital, early in the continuum of care, to an outpatient, skilled nursing facility operated by a division of the hospital organization. A quasi-experimental, cross-sectional, retrospective study is designed to identify and quantify the relationships present in processes and outcomes inherent in health care transitions. Statistical analysis yields unexpected relationships with limited explanatory power for the selected indicators: length of stay, cost of care, discharge delays, 30-day readmissions, falls, and patient satisfaction. However, this research finds 4 imperatives for hospital and clinical leadership: (1) increase collaboration across providers, settings, and stakeholders; (2) educate workforce to optimize risk assessment of aging population; (3) standardize critical to quality measures as scientific foundation for management of services; (4) invest in technologies to ensure the integrity, validity, and reliability of information used to draw inferences about services, risk, and performance.
authors.affiliation: Department of Health Management and Informatics, College of Health and Public Affairs, University of Central Florida, Orlando, Florida 32803-1452, USA. dianne.ross@flhosp.org
authors.forename: Dianne Morrow
authors.initials: DM
authors.lastname: Ross
authors.forename: Bernardo
authors.initials: B
authors.lastname: Ramirez
authors.forename: Timothy
authors.initials: T
authors.lastname: Rotarius
authors.forename: Aaron
authors.initials: A
authors.lastname: Liberman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003363:Cost Control; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D017146:Models, Organizational; D010360:Patient Transfer / Q000191:economics / Q000458:organization & administration*; D011157:Population Dynamics; D019984:Quality Indicators, Health Care; D012046:Rehabilitation; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States