title: Hospital readmission in persons with stroke following postacute inpatient rehabilitation.
abstract: BACKGROUND
  Readmission is an important quality indicator following acute care hospitalization. We examined factors associated with hospital readmission in persons with stroke following postacute inpatient rehabilitation.
  
  
  METHODS
  Prospective cohort study including 674 persons with stroke who received rehabilitation at 11 facilities located in eight states and the District of Columbia. Measures included hospital readmission within 3 months of discharge, sociodemographic characteristics, length of stay, primary payment source, comorbidities, stroke type, standardized assessments of motor and cognitive function, depressive symptoms, and social support.
  
  
  RESULTS
  Mean age was 71.5 years (SD = 10.5). Twenty-five percent of patients reported high depressive symptoms. Overall, 18% (n = 122) of the sample was rehospitalized. Univariate analyses showed that people who were rehospitalized were more likely (p < .05) to be non-Hispanic white, married, demonstrate less functional independence at discharge, experience longer lengths of stay in rehabilitation, and report more depressive symptoms and lower social support. In the fully adjusted multivariable hierarchical generalized linear model, motor functional status (OR = 0.98, 95% CI 0.96-0.99), depressive symptoms (OR = 1.80, 95% CI 1.06-3.05), and social support (OR = 2.28, 95% CI 1.29-4.03) remained statistically significant. In addition, a minority-by-depressive symptoms interaction term also reached statistical significance.
  
  
  CONCLUSIONS
  Functional status, depressive symptoms, and social support were important predictors of hospital readmission. These variables are not included in most administrative data sets. Future research to develop useful risk-adjustment models for rehospitalization following postacute inpatient rehabilitation services should include large diverse samples and explore practical sources for additional meaningful information.
authors.affiliation: Division of Rehabilitation Sciences, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-1137, USA. kottenba@utmb.edu
authors.forename: K J
authors.initials: KJ
authors.lastname: Ottenbacher
authors.forename: J E
authors.initials: JE
authors.lastname: Graham
authors.forename: A J
authors.initials: AJ
authors.lastname: Ottenbacher
authors.forename: J
authors.initials: J
authors.lastname: Lee
authors.forename: S
authors.initials: S
authors.lastname: Al Snih
authors.forename: A
authors.initials: A
authors.lastname: Karmarkar
authors.forename: T
authors.initials: T
authors.lastname: Reistetter
authors.forename: G V
authors.initials: GV
authors.lastname: Ostir
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010359:Patient Readmission / Q000706:statistics & numerical data*; D019984:Quality Indicators, Health Care; D012944:Social Support; D020521:Stroke / Q000453:epidemiology; D000071939:Stroke Rehabilitation