TY - JOUR
T1 - The Relationship between Patient-Specific Factors and Discharge Destination after COVID-19 Hospitalization
AU - Lewis, Christopher W.
AU - Gray, Elizabeth
AU - Dreyer, Sean
AU - Goodman, Daniel
AU - Jayabalan, Prakash
N1 - Funding Information:
Funding statement: Northwestern Medicine Enterprise Data Warehouse Pilot Data Program 2020–2021: funding provided by the Northwestern University Clinical and Translational Sciences Institute (NUCATS) and support, in part, by the National Institutes of Health (NCATS UL1TR001422 and U24TR002306). This funding supported the time of the data scientist to export patient data from the electronic health record. Shirley Ryan AbilityLab Catalyst grant: funding provided by the Northwestern University Clinical and Translational Sciences Institute (NUCATS) and support, in part, by the National Institutes of Health (NCATS UL1TR001422 and U24TR002306). This funding supported database creation and management. Dr Prakash Jayabalan receives support from the National Center for Advancing Translational Sciences (2KL2TR001424-05A1).
Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2023/7/1
Y1 - 2023/7/1
N2 - Objective The aim of this study was to determine the discharge destinations and associated patient-specific factors among patients hospitalized with COVID-19. Design A retrospective cohort study was carried out at a single-site tertiary acute care hospital. Results Among 2872 patients, discharge destination included home without services (n = 2044, 71.2%), home with services (n = 379, 13.2%), skilled nursing facility (117, 4.1%), long-Term acute care hospital (n = 39, 1.3%), inpatient rehabilitation facility (n = 97, 3.4%), acute care facility (n = 23, 0.8%), hospice services (n = 20, 0.7%), or deceased during hospitalization (n = 153, 5.3%). Adjusting by covariates, patients had higher odds of discharge to a rehabilitation facility (skilled nursing facility, long-Term acute care hospital, or inpatient rehabilitation facility) than home (with or without services) when they were older (odds ratio [OR], 2.37; 95% confidence interval [CI], 1.80-3.11; P < 0.001), had a higher Charlson Comorbidity Index score (3-6: OR, 2.36; 95% CI, 1.34-4.15; P = 0.003; ≥7: OR, 2.76; 95% CI, 1.56-4.86; P < 0.001), were intubated or required critical care (OR, 2.15; 95% CI, 1.48-3.13; P < 0.001), or had a longer hospitalization (3-7 days: OR, 12.48; 95% CI, 3.77-41.32; P < 0.001; 7-14 days: OR, 28.14; 95% CI, 8.57-92.43; P < 0.001). Patients were less likely to be discharged to a rehabilitation facility if they received remdesivir (OR, 0.44; 95% CI, 0.31-0.64; P < 0.001). Conclusions Patient-specific factors associated with COVID-19 hospitalization should be considered by physicians when prognosticating patient rehabilitation.
AB - Objective The aim of this study was to determine the discharge destinations and associated patient-specific factors among patients hospitalized with COVID-19. Design A retrospective cohort study was carried out at a single-site tertiary acute care hospital. Results Among 2872 patients, discharge destination included home without services (n = 2044, 71.2%), home with services (n = 379, 13.2%), skilled nursing facility (117, 4.1%), long-Term acute care hospital (n = 39, 1.3%), inpatient rehabilitation facility (n = 97, 3.4%), acute care facility (n = 23, 0.8%), hospice services (n = 20, 0.7%), or deceased during hospitalization (n = 153, 5.3%). Adjusting by covariates, patients had higher odds of discharge to a rehabilitation facility (skilled nursing facility, long-Term acute care hospital, or inpatient rehabilitation facility) than home (with or without services) when they were older (odds ratio [OR], 2.37; 95% confidence interval [CI], 1.80-3.11; P < 0.001), had a higher Charlson Comorbidity Index score (3-6: OR, 2.36; 95% CI, 1.34-4.15; P = 0.003; ≥7: OR, 2.76; 95% CI, 1.56-4.86; P < 0.001), were intubated or required critical care (OR, 2.15; 95% CI, 1.48-3.13; P < 0.001), or had a longer hospitalization (3-7 days: OR, 12.48; 95% CI, 3.77-41.32; P < 0.001; 7-14 days: OR, 28.14; 95% CI, 8.57-92.43; P < 0.001). Patients were less likely to be discharged to a rehabilitation facility if they received remdesivir (OR, 0.44; 95% CI, 0.31-0.64; P < 0.001). Conclusions Patient-specific factors associated with COVID-19 hospitalization should be considered by physicians when prognosticating patient rehabilitation.
KW - Coronavirus
KW - Healthcare Systems
KW - Rehabilitation Utilization
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U2 - 10.1097/PHM.0000000000002159
DO - 10.1097/PHM.0000000000002159
M3 - Article
C2 - 36730027
AN - SCOPUS:85162984766
SN - 0894-9115
VL - 102
SP - 611
EP - 618
JO - American Journal of Physical Medicine and Rehabilitation
JF - American Journal of Physical Medicine and Rehabilitation
IS - 7
ER -