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Comment & Response |

Physical Function and Hospital Readmissions—Reply

S. Ryan Greysen, MD, MHS, MA1; Kenneth E. Covinsky, MD, MPH2,3
[+] Author Affiliations
1Division of Hospital Medicine, University of California San Francisco (UCSF), San Francisco
2Division of Geriatric Medicine, University of California San Francisco, San Francisco
3San Francisco Veterans Affairs Medical Center, San Francisco, California
JAMA Intern Med. 2015;175(10):1723. doi:10.1001/jamainternmed.2015.3925.
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In Reply We agree with Flavey et al that the relationships between physical function, interventions, and outcomes are quite complex. Much like the Transition Care Model by Naylor et al1 they cite, inpatient interventions such as the Acute Care for Elderly model2 are multicomponent programs designed to improve outcomes such as readmission in older adults by preserving or restoring independence in acute and postacute settings. Thus, small improvements in self-reported activities of daily living (ADL) likely add to other improvements such as medication adherence and symptom management to create clinically significant global improvement. We also note that the effects of combining inpatient Acute Care for Elderly and Transition Care Model interventions for older adults is understudied. Future studies should try to tease out the specific role of function in recovery as well as summative effects of these interventions to maximize independence across acute and postacute care settings.


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October 1, 2015
Jason R. Falvey, PT, DPT; Robert E. Burke, MD; Jennifer E. Stevens-Lapsley, PT, PhD
1Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora
2Denver Veterans Affairs Medical Center, Denver, Colorado3University of Colorado School of Medicine, Aurora
JAMA Intern Med. 2015;175(10):1722. doi:10.1001/jamainternmed.2015.3922.
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