{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T19:53:15Z","timestamp":1793303595657,"version":"4.5.0"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,8,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Readmissions in patients with congestive heart failure are common and often preventable. Limited data suggest that patients discharged to a less intensive postacute care setting than recommended are likely to readmit. We examined whether postacute setting discordance (discharge to a less intensive postacute setting than recommended by a physical and occupational therapist) was associated with hospital readmission in patients with congestive heart failure. We also assessed sociodemographic and clinical predictors of setting discordance.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Retrospective analysis of administrative claims and electronic health record data was conducted on 25\u00a0500 adults with a discharge diagnosis of congestive heart failure from 12 acute care hospitals in Western Pennsylvania. Generalized linear mixed models were estimated to examine the association between postacute setting discordance and 30\u2010day hospital readmission and to identify predictors of setting discordance. The 30\u2010day readmission and postacute setting discordance rates were high (23.7%, 20.6%). While controlling for demographic and clinical covariates, patients in discordant postacute settings were more likely to be readmitted within 30\u00a0days (adjusted odds ratio [OR], 1.12; 95% CI, 1.04\u20131.20). The effect was also seen in the subgroup of patients with low mobility scores (adjusted OR, 1.20; 95% CI, 1.08\u20131.33). Factors associated with setting discordance were lower\u2010income, higher comorbidity burden, therapist recommendation disagreement, and midrange mobility limitations.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Postacute setting discordance was associated with an increased readmission risk in patients hospitalized with congestive heart failure. Maximizing concordance between therapist recommended and actual postacute discharge setting may decrease readmissions. Understanding factors associated with post\u2010acute setting discordance can inform strategies to improve the quality of the discharge process.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.020425","type":"journal-article","created":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T08:55:37Z","timestamp":1627548937000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Is Discordance Between Recommended and Actual Postacute Discharge Setting a Risk Factor for Readmission in Patients With Congestive Heart Failure?"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3414-573X","authenticated-orcid":false,"given":"Aileen","family":"Chou","sequence":"first","affiliation":[{"name":"Department of Physical Therapy University of Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey","family":"Euloth","sequence":"additional","affiliation":[{"name":"UPMC Rehabilitation Services Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth","family":"Matcho","sequence":"additional","affiliation":[{"name":"UPMC Rehabilitation Services Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0891-745X","authenticated-orcid":false,"given":"Amy M.","family":"Pastva","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Division of Physical Therapy, and Duke Claude D. Pepper Older Americans Independence Center Duke University School of Medicine Durham NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Bilderback","sequence":"additional","affiliation":[{"name":"Wolff CenterUPMC Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7480-0145","authenticated-orcid":false,"given":"Janet K.","family":"Freburger","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy University of Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","first-page":"E139","article-title":"Heart disease and stroke statistics\u20142020 update: a report from the American Heart Association","author":"Virani SS","year":"2020","unstructured":"Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Delling FN, American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee . 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