Researchers at The Ohio State University Wexner Medical Center, in collaboration with the College of Medicine’s School of Health and Rehabilitation Sciences (HRS), have shed light on a pressing issue affecting older adults in hospital settings. A recent systematic review has uncovered significant links between deficiencies in physical function and the risk of hospital readmissions among individuals aged 50 and older. This research highlights the crucial need for enhanced assessments of physical capability in this demographic, as many patients transition from hospital care to discharge.
The implications of this study are particularly vital when considering that an alarming 17% of Medicare beneficiaries in the United States were readmitted to the hospital within a mere 30 days of discharge between 2016 and 2020. Such high readmission rates place a considerable burden on healthcare systems, as well as on patients and their caregivers. Understanding the factors contributing to these rates is essential for addressing the challenges faced by both healthcare providers and patients, especially among older adults whose medical complexities often complicate their care.
In the words of Erin Thomas, PT, DPT, the lead author of the study and associate professor of practice at HRS, “Physical function is a crucial indicator of underlying health.” However, accurately assessing the risks for patients preparing for discharge has proven to be complex yet vital. This complexity stresses the importance of consistently documenting a patient’s physical function during their hospital stay. Early and frequent evaluations can align the care provided with the priorities and needs of both patients and caregivers upon discharge.
The systematic review referenced in the study examined data from 17 individual studies, drawing from a substantial pool of over 80,000 hospitalized patients between the years 2010 and 2022. This extensive analysis revealed strong associations between functional impairments—ranging from activity limitations to participation restrictions—and the incidence of hospital readmissions across various health conditions. Such conditions include general medical issues, oncological concerns, surgeries related to cardiac health, and post-transplant situations.
Among the physical activities measured by the study were everyday tasks that many may take for granted, such as lifting or carrying weights, walking a quarter of a mile, and raising arms above shoulder height. Other essential activities assessed included bathing, dressing, getting in and out of bed or chairs, performing light housework, preparing meals, and running errands or shopping. These activities illuminate the link between basic physical capabilities and the ability of older adults to function independently post-discharge.
One of the critical observations made by the researchers is the potential missed opportunities during hospitalization, where interventions addressing physical impairments could significantly impact patient outcomes. Identifying functional limitations before patients are discharged allows for targeted interventions aimed at improving those abilities. Consequently, enhancing patients’ functional abilities before they leave the hospital may help prevent future hospitalizations due to reduced function or complications arising from such impairments.
Thomas emphasizes, “Prioritizing functional assessments for all clinicians and making this information widely available to the treatment team at the receiving end of care transitions could pay dividends for individual patients and the older adult population as a whole.” This statement serves as a call to action for all healthcare professionals involved in the care of older adults. By prioritizing functional assessments, clinicians can enhance their understanding of each patient’s unique needs.
The study not only calls attention to the importance of physical function in predicting hospital readmissions but also highlights the necessity of collaborative care models. Better communication and information sharing among healthcare teams are essential to ensure that all aspects of a patient’s physical health are assessed, documented, and acted upon effectively.
Through the support of funding from the American Physical Therapy Association and a grant from the National Institute on Aging, this research has become a pivotal resource for healthcare professionals seeking to improve the quality of care for older adults. Co-author Marka Salsberry, PT, DPT, also of HRS, further contributed to the study’s findings, alongside colleagues from institutions such as the Universities of Colorado, Connecticut, and Maryland, as well as healthcare entities like Intermountain Health in Utah and Washington Hospital Healthcare System in California.
Overall, this systematic review presents a compelling case for enhancing the assessment of physical function within hospital settings for older patients. It highlights an urgent need for healthcare institutions to develop strategies that prioritize functional health assessments as part of routine care. Such measures are essential for minimizing the risk of readmissions, ultimately leading to improved health outcomes and quality of life for older adults.
In conclusion, the findings from this study not only add to the existing body of knowledge on hospital readmissions but also present a strong argument for refocusing healthcare strategies toward comprehensive assessments of physical function. The insights gained from these findings should influence policies, practices, and educational efforts aimed at improving the healthcare trajectories of older patients, fostering a system that values and enhances physical function as a critical component of overall health.
Subject of Research: The link between impairments in physical function and hospital readmission risk among adults 50 years of age and older.
Article Title: Association of physical function with hospital readmissions among older adults: A systematic review
News Publication Date: 4-Nov-2024
Web References: https://wexnermedical.osu.edu | https://medicine.osu.edu | https://shmpublications.onlinelibrary.wiley.com/doi/10.1002/jhm.13538
References: Agency for Healthcare Research and Quality
Image Credits: The Ohio State University Wexner Medical Center
Keywords: physical function, hospital readmissions, older adults, healthcare, rehabilitation, systematic review, Medicare, hospitalization, health outcomes, interventions, quality care, healthcare strategies.
