Abstract
Background Providing patients with optimal discharge disposition and follow-up services could prevent unplanned readmissions. Despite their qualifications, physical therapists are rarely represented on the interdisciplinary team.
Objective This study aimed to determine the relationship between the participation of physical therapists in interdisciplinary discharge rounds and readmission rates.
Methods In this retrospective observational study, patients discharged by 2 interdisciplinary teams with or without a physical therapist's participation were followed for 5 months. Adherence to the physical therapist's recommendations for follow-up services and unplanned 30-day readmissions were tracked. Multiple logistic regression and random forest models were used to determine factors contributing to 30-day readmission rates.
Results The odds of 30-day readmissions were 3.78 times greater when a physical therapist was absent from the interdisciplinary team compared with the odds of 30-day readmissions when a physical therapist participated in the interdisciplinary team. In addition, the odds of 30-day readmission for patients discharged to their home were 2.47 times greater than those who were not discharged to their home. An increased lack of postdischarge services was noted when a physical therapist was not included in the interdisciplinary team.
Limitations The nonrandom selection of patients into groups, the small sample size, and the inability to adjust risk for unknown factors (eg, medical diagnoses, comorbidities, funding, and functional measures) limited interpretation of the results.
Conclusion Significantly higher readmission rates were noted for patients whose interdisciplinary team did not have a physical therapist and for those patients who were discharged to their home. These preliminary findings suggest that discharge from the acute care setting is an elaborate process and should be designed carefully. In order to identify the optimal discharge process, future research should account for patient complexities in addition to the composition of the interdisciplinary discharge team.
Footnotes
Dr Kadivar and Dr English provided concept/idea/research design, data collection, and consultation (including review of manuscript before submission). All authors provided writing. Dr Kadivar and Professor Marx provided data analysis. Dr English provided institutional liaisons and administrative support.
Dr Kadivar and Dr English are Neurologic Certified Specialists.
The authors acknowledge physical therapists Holly Brown, Alicia Bogan, and Lorna Bautista for their contribution to data collections. They also thank managers T.J. Pelton and Anne Miller for helping to facilitate the research project.
- Received April 23, 2015.
- Accepted May 4, 2016.
- © 2016 American Physical Therapy Association
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