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Functional hospital patients fare better

By Meredith Cohn

The Baltimore Sun

3:20 PM EDT, May 5, 2014

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Testing hospital patients on their ability to perform everyday tasks before they are released could go a long way to keeping them from returning to the hospital, new research from Johns Hopkins University suggests.

Tasks such as moving from a bed to a chair, eating, using the toilet and communicating are uniformly assessed after patients go to rehabilitation facilities from hospitals, but function isn’t always tested in a standardized way before they go. And Hopkins researchers found that low scores on a standardized test of the tasks was a good predictor of hospital readmission.  

Improving a patient’s abilities before they leave could not only benefit the patient but the hospital’s bottom line. Medicare is now penalizing hospitals when patients return within 30 days.

"The Functional Independence Measure score is a direct reflection of a patient's ability to heal," said Dr. Erik Hoyer, an assistant professor in Hopkins' Department of Physical Medicine and Rehabilitation and the department's deputy director of quality and safety. "When a person cannot move his or her legs or use the bathroom independently, for example, it's telling us something about the body's physiologic reserve, its overall ability to be resilient to disease."

The research was published in the May issue of the Journal of Hospital Medicine.

Hoyer and other researchers tracked the test scores for more than 9,000 patients admitted to rehab facilities from hospitals between 2006 and 2012 and if they were readmitted to the hospital. They found those with low scores were two to three times more likely to be readmitted within 30 days.

Hoyer said hospitals aren't as focused on ensuring patients are mobile and functional before they leave.

"Helping patients become more functional before they leave the hospital is important not just for Medicare policy, but also for patients' overall hospital experience and quality of life when they leave," he said in a statement. "When you talk about whether someone can use a bedpan or the toilet, it's a question of dignity."