Functional Status and Hospital Readmissions Using the Medical Expenditure Panel Survey

J Gen Intern Med. 2015 Jul;30(7):965-72. doi: 10.1007/s11606-014-3170-9. Epub 2015 Feb 18.

Abstract

Background: Hospital readmissions are expensive and they may signal poor quality of care. Whether functional status is related to hospital readmissions using a representative U.S sample remains unexplored .

Objective: We aimed to assess the relationship between functional status and all-cause 30-day hospital readmissions using a representative sample of the US population.

Design: This was a retrospective observational study (2003-2011).

Patients: The study included 3,772 patients who completed the SF-12 before being hospitalized. Three hundred and eighteen (8.4%) were readmitted within 30 days after being discharged.

Measurements: The Medical Expenditure Panel Survey (MEPS) was employed. Functional status was measured with the Short-Form 12-Item Health Survey Version 2® (SF-12). The probability of being readmitted was estimated using a logistic model controlling for demographic characteristics, comorbid conditions, insurance coverage, physical (PCS) and mental (MCS) summaries of the SF-12, reason for hospitalization, length of hospital stay, region, and residential area.

Results: A one-unit difference in PCS reduced the odds of readmission by 2% (odds ratio 0.98 [95% CI, 0.97 to 0.99]; p < 0.001), which implies an 18% reduction in the odds of readmissions for a ten-unit difference (one standard deviation) in PCS. The c-statistic of the model was 0.72.

Conclusion: Baseline physical function is associated with hospital readmissions. The SF-12 improves the ability to identify patients at high risk of hospital readmission.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Comorbidity
  • Female
  • Health Expenditures / statistics & numerical data*
  • Health Status Indicators
  • Health Status*
  • Hospitalization / statistics & numerical data
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Patient Readmission / economics
  • Patient Readmission / statistics & numerical data*
  • Physical Fitness*
  • Retrospective Studies
  • United States
  • Young Adult