Sociodemographics tied to rehab use during critical illness hospitalization

For older adults hospitalized with a stay in the intensive care unit (ICU), social determinants of health (SDOH) are associated with use of skilled rehabilitation, according to a study published online May 10 in JAMA Network Open.

Snigdha Jain, M.D., from the Yale School of Medicine in New Haven, Connecticut, and colleagues examined whether SDOH are associated with the delivery of skilled rehabilitation during critical illness hospitalization among older adults in a cohort study using data from the National Health and Aging Trends Study linked with Medicare claims. Participants included older adults hospitalized with a stay in the ICU; the sample included 1,618 ICU hospitalizations.

The researchers found that 22.9 percent of the hospitalizations were among patients with dual Medicare and Medicaid eligibility, and 32.6, 19.8, and 3.5 percent were among patients with less than high school education, rural residence, and limited English proficiency, respectively.

Overall, 68.5 percent of 1,076 hospitalized patients received any physical therapy (PT) or occupational therapy (OT). Factors associated with lower odds of receipt of PT or OT included dual Medicare and Medicaid eligibility and rural residence, after adjustment for confounding variables (adjusted odds ratios, 0.70 and 0.65, respectively). A lower rate of PT or OT was seen in association with limited English proficiency (adjusted rate ratio, 0.55).

"Our findings highlight the need to consider these SDOH in efforts to enhance equitable delivery of skilled rehabilitation services during hospitalization," the authors write.

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