Table 2 –
Resident Characteristics and Outcomes by INTERACT Use Groups
|
Low Use N = 34 |
Increased Use N = 65 |
High Use N = 101 |
SNFs with Missing Data1 N = 64 |
P-value (Differences Among Groups 1–3) |
|
|---|---|---|---|---|---|
| Baseline resident characteristics (Jan. 2012-Feb. 2013) | |||||
| Unique resident- facility pairs |
10,187 | 17,841 | 26,884 | 17,846 | |
| Age (years) | 81.6 (10.2) | 80.9 (10.8) | 79.6 (11.5) | 81.6 (10.6) | 0.007 |
| Female (%) | 68% | 65% | 63% | 66% | 0.004 |
| White non-Hispanic (%) |
83% | 82% | 78% | 89% | 0.567 |
| Black non-Hispanic (%) |
15% | 16% | 15% | 7% | 0.952 |
| Hispanic (%) | 1% | 1% | 3% | 1% | 0.003 |
| Asian/other (%) | 1% | 1% | 4% | 2% | 0.030 |
| Hierarchical Care Category Score2 |
1.33 (1.13) | 1.46 (1.22) | 1.48 (1.25) | 1.43 (1.18) | 0.029 |
| Dual Medicare/Medicaid status (%) |
22% | 29% | 36% | 29% | 0.003 |
| Any Part A days (%) |
76% | 70% | 73% | 72% | 0.101 |
| Total Part A days (in period) |
24.0 (26.3) | 25.4 (30.5) | 25.9 (29.3) | 24.4 (27.6) | 0.208 |
| Late Loss Activity of Daily Living (ADL) Score (range: 0 – 16) |
7.4 (4.2) | 7.9 (4.6) | 7.6 (4.4) | 8.2 (4.6) | 0.267 |
| Complete dependence, any late loss ADL (ever in period) (%) |
18% | 23% | 22% | 21% | 0.369 |
| Terminal diagnosis (ever in period) (%) |
4% | 4% | 4% | 6% | 0.939 |
| Severe cognitive disability (%)3 |
9% | 9% | 11% | 9% | 0.430 |
| Outcome Rates during Baseline (Jan. 2012-Feb. 2013) | |||||
| All cause hospitalizations |
3.53 (1.59) | 3.81 (1.49) | 3.62 (1.47) | 3.57 (1.36) | 0.149 |
| Potentially avoidable hospitalizations |
1.09 (0.82) | 1.17 (0.80) | 1.14 (0.73) | 1.10 (0.73) | 0.606 |
| ED visits without admission |
1.86 (1.21) | 2.14 (1.17) | 1.89 (1.19) | 1.90 (1.03) | 0.041 |
| Readmission rate | 0.20 (0.18) | 0.21 (0.16) | 0.21 (0.16) | 0.21 (0.15) | 0.394 |
| Outcome Rates during Intervention (Mar. 2013-Feb. 2014) | |||||
| All cause hospitalizations |
3.44 (1.53) | 3.39 (1.36) | 3.37 (1.41) | 3.29 (1.28) | 0.921 |
| Potentially avoidable hospitalizations |
1.02 (0.76) | 0.95 (0.72) | 1.00 (0.68) | 0.94 (0.66) | 0.558 |
| ED visits without admission |
1.94 (1.17) | 2.07 (1.09) | 1.79 (1.09) | 1.95 (1.10) | 0.009 |
| Readmission rate | 0.19 (0.17) | 0.20 (0.17) | 0.20 (0.17) | 0.20 (0.17) | 0.672 |
Notes:
Definitions on INTERACT use groups are provided in Supplemental Appendix S1.
Resident characteristics are reported as percentages or means (unweighted) and standard deviations. N represents unique facilities. Data on outcomes (from facility-month level data) are reported as means (weighted by total resident days, except for readmission rate, the means of which are weighted by the number of index hospitalizations) and standard deviations. Outcomes are measured by per 1,000 resident days (except for readmission rate, which is a proportion of index hospitalizations that were associated with a hospital readmission within 30 days), adjusted for resident and facility characteristics. For example, rates of 3.0–4.0 for all cause admissions in a typical SNF with a resident census of 100 would mean 3–4 hospital admissions every 10 days. Standard errors are clustered at the SNF level.
64 facilities did not report data and use of Stop and Watch or SBAR at baseline or follow up.
Hierarchical Condition Category score ranges from 0.12 to 13.52; 1st percentile, median, and 99th percentile are 0.30, 0.95 and 5.80 respectively.
MDS-derived Cognitive Performance Scale Score = 5, 6.