title: Rate of return to acute care hospital based on day and time of rehabilitation admission.
abstract: OBJECTIVE
  To determine if a patient's return to the acute care hospital (RTACH) from an inpatient rehabilitation facility (IRF) because of medical acuity is affected by the day of the week and time of rehabilitation admission.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Inpatient rehabilitation facility.
  
  
  METHODS
  All adult patients admitted to the IRF from January 1, 2009, to June 30, 2011. RTACH was defined as an interruption in the patients' rehabilitation course as a result of medical and/or surgical complications requiring a higher level of care. The control group was defined as patients who completed an uninterrupted rehabilitation course. The study included 2282 patients (2026 control patients and 256 case patients).
  
  
  METHODS
  We compared patient demographics, admission impairment groups, discharge diagnosis, admission and discharge Functional Independent Measure (FIM) scores, length of stay, attached hospital versus outside hospital admissions, and RTACH rates between case patients and control patients.
  
  
  RESULTS
  Out of 2282 patients admitted to the IRF over a 30-month period, 256 patients (10.85%) required an RTACH for a higher level of care not available in the IRF. Two statistically significant results were found for RTACH, including rehabilitation admission time and FIM scores (admission motor and cognition scores). Day of the week for inpatient rehabilitation admission was not statistically significant.
  
  
  CONCLUSIONS
  This study found that the later in the day a patient was admitted to the IRF, the higher the rate of RTACH. In addition, a lower Motor FIM score was found to be correlated with a higher rate of RTACH. Admission day of the week was not found to be statistically significant with regard to the rate of RTACH. Further research is needed to determine the underlying contributing factors that would help decrease the rate of RTACH.
authors.affiliation: East Carolina University and Pitt County Memorial Hospital/Vidant Medical Center, Greenville, NC(∗). Electronic address: faulkc@ecu.edu.
authors.forename: Clinton E
authors.initials: CE
authors.lastname: Faulk
authors.forename: Natalie R
authors.initials: NR
authors.lastname: Cooper
authors.forename: Judit A
authors.initials: JA
authors.lastname: Staneata
authors.forename: Michael P
authors.initials: MP
authors.lastname: Bunch
authors.forename: Enrique
authors.initials: E
authors.lastname: Galang
authors.forename: Xiangming
authors.initials: X
authors.lastname: Fang
authors.forename: Keith J
authors.initials: KJ
authors.lastname: Foster
mesh_terms: D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors