Inpatient Physical Therapy After CAP Reduced Readmissions

Thirty minutes of PT daily kept seniors from returning to hospital. (c)Blend Images/Shutterstock.com

Undergoing even just brief periods of hospital-based physical therapy reduced the all-cause 30-day readmission rate among hospitalized older adults with community-acquired pneumonia (CAP) with declining physical function, according to the results of a retrospective study published in Aging and Disease.

“Our study contributes to the literature by providing evidence that physical therapy reduces progressive functional decline, even in common acute illness (pneumonia),” wrote Sun Jun Kim, of the University of Michigan School of Public Health, and colleagues. “Hospital-based physical therapy reduces vulnerability to other episodes of acute illnesses, and consequently reduces the early hospital readmission rate.”

Kim and colleagues examined a group of 1058 community-dwelling older adults who had been admitted to the medicine floor for CAP. During their hospital stay, included patients had a decline in their physical function as measured by the Katz Activities of Daily Living (ADL) scale.

The researchers compared the outcomes among those patients who underwent physical therapy for at least one-half hour every day with those who did not.

No differences in the Katz ADL scale were found between patients who underwent physical therapy (mean 4.89) and those who did not (mean 4.23).

However, the researchers did find a decrease in all-cause 30-day readmission rate for those patients who underwent physical therapy compared with those who did not in both the unadjusted (11.2% vs 16.3%; P=.03) and multivariate analyses (OR=0.65; P=.02). They found that higher severity of illness, cognitive impairment, and complex comorbidity all were associated with an increased all-cause 30-day hospital readmission rate.

According to the researchers, the positive findings of this study based on hospital-based physical therapy utilization may have several implications, including system-wide benefits for hospitals.

“Medicare launched a performance-based payment system for certain medical conditions (heart failure, pneumonia, and acute myocardial infarction) in 2013. Thirty-day hospital readmission, also known as the ‘revolving door phenomenon,’ is one of the core performance indicators linked to hospital reimbursement from Medicare,” the researchers wrote. “Reduction of 30-day hospital readmission rates would improve performance indicators, and thus also improve the financial status of hospitals.”

References:

Kim SJ, Lee JH, Han B, et al. Effects of hospital-based physical therapy on hospital discharge outcomes among hospitalized older adults with community-acquired pneumonia and declining physical function.Aging Dis. 2015;6:174-179.