Older Adult Care Transition Experience Following Inpatient Rehabilitation
Abstract
The internationally used 15 item Care Transition Measure (CTM-15) has been primarily used to assess the care transition experience among adults transitioning from acute care to home. Although the CTM-15’s psychometric properties have been established in this population, the ability of the CTM-15 to reliably discriminate a good from a bad care transition experience among older adults (60 or more years of age) moving from an inpatient rehabilitation setting to home is unclear. The purpose of this prospective observational cohort study was to: 1) evaluate the psychometric properties of the CTM-15 when used among older adults transitioning from an inpatient rehabilitation setting to home, 2) identify the factors associated with this care transition experience, and 3) explore and compare the care transition experience of patients discharged from two different specialized clinical treatment units.
Baseline data were collected via face-to-face interviews prior to discharge, and by telephone at both 2 to 6 days and at 28 to 32 days post discharge directly from patients. Although 64 patients were consented, complete data were available from 50 patients (mean age: 80.4 years). The CTM-15 demonstrated both internal consistency (Cronbach’s alpha = 0.91 at 2 to 6 days post discharge) and test retest reliability (ICC2,2 = 0.78). Increased age, decreased function (as measured by the Functional Independence Measure), and increased length of stay were significantly associated with a poorer care transition experience. However, only 20% of the overall variance in averaged CTM-15 scores was explained. In addition, the relationship between length of stay and care transition experience differed significantly by unit.
Subject to two administrations, the CTM-15 is a reliable and valid discriminative measure of care transition experience when used with older adults transitioning from an inpatient rehabilitation setting to home. Future studies exploring such a care transition need to account for age, function, and length of stay either in the study design and/or the analysis. The observed interaction between length of stay and unit should also be further investigated.