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.
S. Ryan Greysen, Kenneth E. Covinsky. Physical Function and Hospital Readmissions—Reply. JAMA Intern Med. 2015;175(10):1723. doi:10.1001/jamainternmed.2015.3925