title: Intensified rehabilitation therapy and transitions to skilled nursing facilities in community-living seniors with acute medical illnesses.
abstract: OBJECTIVE
  To examine whether rehabilitation therapy type would be associated with transitions to skilled nursing facilities (SNF) in community-living seniors with acute medical illnesses.
  
  
  METHODS
  Using administrative and clinical data, multivariate regression analysis examined the relationship between the extent of rehabilitation therapy and transitions to SNF in all participants, as well as participants by physical function at admission.
  
  
  RESULTS
  In all participants (n=929), the intensified rehabilitation therapy was associated with a lower probability of transitions to SNF (14% vs 21%; odds ratio [OR] 0.59; 95% confidence intervals [CI] 0.22-0.96; P=0.02). In participants with mild physical limitations (n=270), less frequent transitions to SNF occurred when patients received intensified rehabilitation therapy [16% vs 23%; OR 0.46; 95% CI 0.17-0.94; P=0.01]. In participants with moderate to severe physical limitations (n=265), the decreased frequency of transitions to SNF associated with rehabilitation therapy became more pronounced (18% vs 28%; OR 0.34; 95% CI 0.07-0.89; P=0.004). By contrast, in participants without physical limitation (n=394), the number of transitions to SNF did not change significantly when they received intensified rehabilitation therapy (P=0.53).
  
  
  CONCLUSIONS
  We found a significant relationship between intensified rehabilitation therapy and the decrease of transitions to SNF in community-living seniors with acute medical illness. The magnitude of this relationship increased in participants with more physical limitations, but not in participants without physical limitations at admission.
authors.affiliation: Department of Internal Medicine, University of Michigan Medical School, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan 48109, USA. yoojiw@trinity-health.org
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Yoo
authors.forename: Sulgi
authors.initials: S
authors.lastname: Kim
authors.forename: Jai Hyun
authors.initials: JH
authors.lastname: Choi
authors.forename: Woo Sang
authors.initials: WS
authors.lastname: Ryu
mesh_terms: D000203:Activities of Daily Living; D000208:Acute Disease / Q000534:rehabilitation*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients; D008297:Male; D026741:Physical Therapy Modalities; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D012866:Skilled Nursing Facilities; D016896:Treatment Outcome; D014481:United States; D016138:Walking / Q000502:physiology*