World Health Organization disability assessment schedule 2.0 (WHODAS 2.0) and risk of readmission among older patients discharged from the ED - a prospective cohort study

Abstract

The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) may be highly relevant in clinical practice for identifying older patients at risk of readmission, and thus in need of rehabilitation or other healthcare services. The objective of this study is to examine the association between WHODAS 2.0 score and unplanned readmission within 26 weeks in older patients discharged from the emergency department and to examine changes in WHODAS 2.0 score between baseline and 26 weeks follow-up.

The study is based on a prospective cohort study of 129 older patients discharged from a Danish ED. The patients completed 36 items, WHODAS 2.0 at discharge and at 26 weeks. The association between WHODAS 2.0 scores at baseline and risk of readmission within 26 weeks were analyzed and differences in WHODAS 2.0 scores after discharge were examined.

The findings revealed that the mobility and self-care domains scores at baseline, with cutoff points for low and high scores, were associated with a greater risk of readmission within 26 weeks (p < 0.05). There were significant differences in mean WHODAS 2.0 summary scores between baseline at discharge and 26 weeks (n = 76, -7.7 points, p < 0.001).

In conclusion, higher scores in the mobility and self-care domain indicated greater risk of readmission within 26 weeks. The patients reported improvements in functioning from discharge to 26 weeks follow up. WHODAS 2.0 could be valuable as an instrument to identify older patients with a higher risk of readmission.

Keywords
Whodas 2.0; Elderly; Readmission; Functioning; Disability; Rehabilitation; Emergency care