Rehabilitation Services, Intermountain Healthcare, Salt Lake City, Utah; Doctor of Physical Therapy Department, Rocky Mountain University, Provo, Utah.
Rehabilitation Services, Intermountain Healthcare, Salt Lake City, Utah.
Arch Phys Med Rehabil. 2023 Sep;104(9):1394-1401. doi: 10.1016/j.apmr.2023.03.011. Epub 2023 Apr 4.
To discover if quality indicator (QI) codes are associated with patient falls in inpatient rehabilitation facilities (IRFs).
This retrospective cohort study explored differences between patients who fell and those who did not fall. We analyzed potential associations between QI codes and falls using univariable and multivariable logistic regression models.
We collected data from electronic medical records at 4 IRFs.
In 2020, our 4 data collection sites admitted and discharged a total of 1742 patients older than 14 years . We only excluded patients (N=43) from statistical analysis if they were discharged before admission data had been assigned.
Not applicable.
Using a data extraction report, we collected age, sex, race and ethnicity, diagnosis, falls, and QI codes for communication, self-care, and mobility performance. Staff documented communication codes on a 1-4 scale and self-care and mobility codes on a 1-6 scale, with higher codes representing greater independence.
Ninety-seven patients (5.71%) fell in the 4 IRFs over a 12-month period. The group who fell had lower QI codes for communication, self-care, and mobility. When adjusting for bed mobility, transfer, and stair-climbing ability, low performance with understanding, walking 10 feet, and toileting were significantly associated with falls. Patients with admission QI codes below 4 for understanding had 78% higher odds of falling. If they were assigned admission QI codes below 3 for walking 10 feet or toileting, they had 2 times greater odds of falling. We did not find a significant association between falls and patients' diagnosis, age, sex, or race and ethnicity in our sample.
Communication, self-care, and mobility QI codes appear to be significantly associated with falls. Future research should explore how to use these required codes to better identify patients likely to fall in IRFs.
探讨质量指标(QI)代码是否与住院康复机构(IRF)中的患者跌倒有关。
本回顾性队列研究比较了跌倒患者和未跌倒患者之间的差异。我们使用单变量和多变量逻辑回归模型分析了 QI 代码与跌倒之间的潜在关联。
我们从 4 家 IRF 的电子病历中收集数据。
2020 年，我们的 4 个数据收集地点共收治和出院了 1742 名年龄大于 14 岁的患者。我们仅排除了那些在入院数据分配之前就出院的患者（N=43），未将其纳入统计分析。
不适用。
使用数据提取报告，我们收集了年龄、性别、种族和民族、诊断、跌倒和沟通、自理和移动能力的 QI 代码。工作人员根据沟通能力、自理能力和移动能力将代码记录为 1-4 级，数字越高表示独立性越强。
在 4 家 IRF 的 12 个月期间，有 97 名患者（5.71%）跌倒。跌倒组的沟通、自理和移动能力的 QI 代码较低。在调整床位移动、转移和爬楼梯能力后，理解能力差、行走 10 英尺和如厕能力差与跌倒显著相关。入院 QI 代码理解能力低于 4 分的患者跌倒的可能性增加 78%。如果他们的入院 QI 代码在行走 10 英尺或如厕方面低于 3 分，他们跌倒的可能性增加 2 倍。在我们的样本中，没有发现跌倒与患者的诊断、年龄、性别或种族和民族之间存在显著关联。
沟通、自理和移动能力的 QI 代码似乎与跌倒显著相关。未来的研究应该探索如何使用这些必需的代码来更好地识别可能在 IRF 中跌倒的患者。
