Prognostic Factors of Functional Status Improvement in Individuals Admitted to Convalescence Care Units

Objectives: Convalescence care strives to achieve functional recovery of individuals, reducing likelihood of institutionalisation or re-hospitalisation. This work assesses the efficacy of convalescence units in Catalonia, and identifies prognostic factors related to functional improvement.Design and setting: Retrospective analysis of information system data for 11,945 stays in convalescence units with admission and discharge within 2009.Measurements: Main outcome is functional improvement, defined as the reduction of the number of dependent activities of daily life (ADL) between admission and discharge. Other outcomes were functional and cognitive status, Resource Utilization Groups III (RUG III) resource use categories, coverage and intensity of therapies, diagnosis, comorbidities and medical procedures. Logistic regression analyses were performed to identify factors related to functional improvement.Results: Functional improvement was reached in 5618 individuals (47.0%). It was more likely in patients admitted from acute care hospitals (49.5%) than for other procedences (41.6%). Less than two thirds of the sample (63.5%) were able to return to their usual residence. Median length of stay was 35 days, and 93% of patients were discharged at three months. Identified negative factors that decreased the likelihood of functional improvement: cognition and alertness outcomes, complexity, RUG III categories, functional status and therapies received. Positive factors were: less than 9 dependent ADL, and intensity of training in walking skills and dressing/grooming.Conclusion: Based on the identified prognostic factors for functional improvement, convalescence unit users may be classified by rehabilitative expectatives according to their diagnosis and degree of functional and cognitive impairment at admission. (C) 2015 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.