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The purpose of this study was to identify if AM-PAC “6-clicks” could predict discharge from an acute hospitalization to home with home health services or inpatient rehabilitation as compared to discharge to self-care at home in adults with COPD. A retrospective review of electronic medical record data comprised of AM-PAC “6-clicks” basic mobility or daily activity scores at physical or occupational therapy evaluation and discharge was completed. Multinomial logistic regression analyses were performed to determine if AM-PAC “6-clicks” scores could predict discharge to inpatient rehabilitation or home health services with the reference of home with self-care while controlling for age, insurance type, and gender. Receiver operating characteristic curves were created to determine the AM-PAC “6-clicks” scores with the best sensitivity/specificity to determine discharge to home with/without further rehab services. Logistic regression models indicated that basic mobility scores at discharge had the best sensitivity and specificity for discharge home with or without home health-care services. Daily activity scores at either evaluation or discharge are similar in their contribution to discharge status. In adults with COPD basic mobility scores on the AM-PAC “6-clicks” measure completed at discharge had the best sensitivity and specificity for predicting discharge to home and need for rehab services.

Determinants of acute care discharge in adults with chronic obstructive pulmonary disease