Date Presented 04/6/21 This study explores predictors of occupational competence and hospital readmission for clients with chronic conditions in acute care. Self-care function (β = 0.43, p = .01) and environmental impact (β = –.38, p = .01) significantly predict occupational competence. Functional cognition (OR = 2.19, p = .04) and occupational competence (OR = 0.81, p = .02) significantly predict hospital readmission. OTs should consider standardized measures of these predictors to facilitate successful discharge home. Primary Author and Speaker: Melanie Tkach Additional Authors and Speakers: John R. Patro, Emily Gavin

Readmissions to health care facilities are undesirable outcomes that indicate the quality of the care transitions. Although there is a growing evidence-base for preventing readmissions, the focus has been on acute care. Postacute care (PAC) patients are often excluded from these studies, and thus there is limited evidence guiding practitioners’ efforts to facilitate an effective community transition after PAC rehabilitation. To provide direction for PAC research and clinical practice, this scoping review summarizes current community transition interventions and identifies practices that facilitate successful community discharge. Thirteen care processes emerged from 35 studies, of which 5 were included in at least 60% of the studies, including coaching on the care transition process, medical self-management, medication self-management, scheduling follow-up medical services, and telephone follow-up. These findings can inform the development, evaluation, and implementation of PAC community transition interventions.

The passage of the Patient Protection and Affordable Care Act of 2010 (ACA; Pub. L. 111–148) represents the largest expansion in government funding of health care since Medicare and Medicaid were established in 1965 ( Curfman, Abel, & Landers, 2012 ). Although the health insurance mandate and Medicaid expansion have received the most attention as a result of legal challenges and the July 2012 Supreme Court ruling on the legality of the ACA ( Henry J. Kaiser Family Foundation, 2012 ), other ACA initiatives may have even greater implications for occupational therapy. The ACA includes sections on improving quality and health systems performance for Medicare recipients, with some sections also applying to Medicaid recipients. Insurance companies commonly follow Medicare rules; therefore, the Medicare reforms are likely to spread across all payers, health care settings, and care recipients.