Health Policy Manag.  2021 Dec;31(4):451-461. 10.4332/KJHPA.2021.31.4.451.

Factors Influencing Readmission of Convalescent Rehabilitation Patients: Using Health Insurance Review and Assessment Service Claims Data

• Shin YH
• Jeong HS

• KMID: 2525768
• DOI: http://doi.org/10.4332/KJHPA.2021.31.4.451

Abstract

Background
Readmissions related to lack of quality care harm both patients and health insurance finances. If the factors affecting readmission are identified, the readmission can be managed by controlling those factors. This paper aims to identify factors that affect readmissions of convalescent rehabilitation patients.
Methods
Health Insurance Review and Assessment Service claims data were used to identify readmissions of convalescent patients who were admitted in hospitals and long-term care hospitals nationwide in 2018. Based on prior research, the socio-demographics, clinical, medical institution, and staffing levels characteristics were included in the research model as independent variables. Readmissions for convalescent rehabilitation treatment within 30 days after discharge were analyzed using logistic regression and generalization estimation equation.
Results
The average readmission rate of the study subjects was 24.4%, and the risk of readmission decreases as age, length of stay, and the number of patients per physical therapist increase. In the patient group, the risk of readmission is lower in the spinal cord injury group and the musculoskeletal system group than in the brain injury group. The risk of readmission increases as the severity of patients and the number of patients per rehabilitation medicine specialist increases. Besides, the readmission risk is higher in men than women and long-term care hospitals than hospitals.
Conclusion
“Reducing the readmission rate” is consistent with the ultimate goal of the convalescent rehabilitation system. Thus, it is necessary to prepare a mechanism for policy management of readmission.

Keyword

Convalescent; Rehabilitation; Patient readmission; Health Insurance Review and Assessment Service claims data; Generalization estimation equation