Quantifying the Risk for Hospital Readmission When Physical Therapist Discharge Recommendations Are Not Followed

Abstract

Purpose: Studies suggest that implementing physical therapist discharge recommendations decreases 30-day hospital readmissions but may have miscounted readmissions. The purpose of this study was to obtain accurate readmission data and calculate the risk for readmission when therapists' recommendations are not followed. Methods: We conducted this prospective cohort study at a hospital in the Northwestern United States. Two hundred sixty-nine hospitalized participants with physical therapy orders consented to medical record data extraction and participated in a follow-up phone call. We compared physical therapist discharge recommendations to the actual discharge setting and services established for participants as documented in their medical record. Thirty days after discharge, we called participants to ask whether they had been readmitted to any hospital. We then analyzed associations between readmissions and the mismatch of therapist recommendations and participants' actual discharge locations and services received. Results: Twenty-one percent of discharges did not match the location and/or services recommended by the physical therapist. Sixty-six of the 269 participants were readmitted within 30 days. The odds for readmission were 2.3 times greater among participants who did not discharge to the location with the services recommended by their physical therapist. Conclusions: When physical therapist discharge location and services recommendations are not implemented, patients have increased risk of hospital readmission. This finding should inform stakeholders involved in discharge planning on the effect of following recommendations.