Impact of Acute Care OT on Unplanned Hospital Readmission for Patients With Traumatic Brain Injury

Readmissions are associated with poor patient outcomes, such as deconditioning, higher risk for mortality, and higher levels of stress. Thus, reducing readmissions is a top priority for the United States healthcare system. Limited knowledge exists about the relationship between the Activity Measure for Post-Acute Care’s (AM-PACTM) ‘6-Clicks’ daily activity scores at discharge and unplanned readmission in adults with Traumatic Brain Injury (TBI). To address this gap in knowledge, we used a retrospective cross-sectional study design with de-identified electronic health records data from a single health system between January 2018 and December 2021. Inclusion criteria were (1) individuals aged 18 years or greater, (2) admitted with a TBI diagnosis, (3) survived hospitalization, (4) had at least one OT evaluation/treatment session, and (5) complete data for the variables of interest. We used multiple logistic regression analyses to evaluate the association between AM-PAC daily activity scores and 30-day readmission (yes/no). The sample included 829 patients of which 53 were readmitted within 30 days. Discharge AM-PAC scores were not associated with 30-day readmission. However, among several covariates, including sex, race, significant other status, insurance type, and TBI severity, only insurance type was significantly associated with 30-day readmission. Further research is needed to determine whether our results can be generalized beyond the single health system used in this study. Our results inform occupational therapists on which patient factors may contribute to a higher risk of readmission for patients hospitalized with TBI. If patients who are high-risk for readmission are identified early, occupational therapists may be able to provide needed resources, targeted care, and support to reduce their readmission risk.

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