Rehabilitation Providers' Prediction of the Likely Success of the SNF-to-Home Transition Differs by Discipline.
Rehabilitation Providers' Prediction of the Likely Success of the SNF-to-Home Transition Differs by Discipline.
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康复服务提供者对 SNF 到家庭过渡可能成功的预测因学科而异。
DOI：
10.1016/j.jamda.2018.11.015
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发表时间：
2019
影响因子：
7.6
通讯作者：
Conwell,Yeates
中科院分区：
文献类型：
--
作者：
Simning,Adam;Caprio,ThomasV;Seplaki,ChristopherL;Conwell,Yeates
目标我们文章的主要目的是检查康复提供者是否可以预测哪些从熟练护理机构 (SNF) 康复出院的患者将成功过渡到家庭，控制社会人口因素以及身体、心理和社会健康特征。设计纵向队列研究。设置和参与者 12 名 65 岁及以上的英语成年人入住 2 个 SNF 康复中心 措施我们的结果是“未能过渡到家庭”，它确定了在研究期间未成功从 SNF 过渡到家庭的 SNF 康复患者。我们的主要自变量包括医疗服务提供者、职业治疗师、物理治疗师和社会工作者对其患者从 SNF 到家庭过渡的可能成功的预测。我们还研究了社会人口因素以及身体、心理和社会健康与回家失败之间的关系。结果职业和物理治疗师的预测与患者是否成功从 SNF 回家的双变量相关[风险比 (HR)=4.96，P=.014； HR = 10.91，P= .002，分别]和多变量（HR = 5.07，P= .036；HR = 53.33，P= .004）分析。然而，医疗服务提供者和社会工作者的预测与我们的双变量（HR = 1.44，P= .512；HR = 0.84，P= .794）或多变量（HR = 0.57，P= .487；HR = 0.54，P= .665）分析结果无关。独居、更多的医疗状况、较低的身体功能评分和较高的抑郁评分也与未能回家的时间相关。结论/意义这些研究结果表明，职业治疗师和物理治疗师可能比其他康复提供者更好地预测 SNF 出院后的结果。为什么职业治疗师和物理治疗师的预测与 SNF 到家结果相关，而医疗服务提供者和社会工作者的预测则不然，尚不清楚。更好地了解职业治疗师和物理治疗师出院后预测的因素可能有助于找到改进 SNF 到家庭出院计划流程的方法。
ObjectivesOur article's primary objective is to examine whether rehabilitation providers can predict which patients discharged from skilled nursing facility (SNF) rehabilitation will be successful in their transition to home, controlling for sociodemographic factors and physical, mental, and social health characteristics.DesignLongitudinal cohort study.Setting and ParticipantsOne hundred-twelve English-speaking adults aged 65 years and older admitted to 2 SNF rehabilitation units.MeasuresOur outcome is time to “failed transition to home,” which identified SNF rehabilitation patients who did not successfully transition from the SNF to home during the study. Our primary independent variable consisted of the prediction of medical providers, occupational therapists, physical therapists, and social workers about the likely success of their patients' SNF-to-home transition. We also examined the association of sociodemographic factors and physical, mental, and social health with a failed transition to home.ResultsThe predictions of occupational and physical therapists were associated with whether patients successfully transitioned from the SNF to their homes in bivariate [hazard ratio (HR) = 4.96,P= .014; HR = 10.91,P= .002, respectively] and multivariate (HR = 5.07,P= .036; HR = 53.33,P= .004) analyses. The predictions of medical providers and social workers, however, were not associated with our outcome in either bivariate (HR = 1.44,P= .512; HR = 0.84,P= .794, respectively) or multivariate (HR = 0.57,P= .487; HR = 0.54,P= .665) analyses. Living alone, more medical conditions, lower physical functioning scores, and greater depression scores were also associated with time to failed transition to home.Conclusions/ImplicationsThese findings suggest that occupational and physical therapists may be better able to predict post-SNF discharge outcomes than are other rehabilitation providers. Why occupational and physical therapists' predictions are associated with the SNF-to-home outcome whereas the predictions of medical providers and social workers are not is uncertain. A better understanding of the factors informing the postdischarge predictions of occupational and physical therapists may help identify ways to improve the SNF-to-home discharge planning process.