Citation

Graham JE, Granger CV, Karmarkar AM, Deutsch A, Niewczyk P, DiVita MA, Ottenbacher KJ. Am. J. Phys. Med. Rehabil. 2014; 93(3): 231-244.

Affiliation

From the Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston (JEG, AMK, KJO); Uniform Data System for Medical Rehabilitation, Buffalo, New York (CVG, PN, MAD); Rehabilitation Institute of Chicago, Illinois (AD); Department of Physical Medicine and Rehabilitation and Institute for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (AD); and RTI International, Washington, DC (AD).

Copyright

(Copyright © 2014, Lippincott Williams and Wilkins)

DOI

10.1097/PHM.0b013e3182a92c58

PMID

24088780

PMCID

PMC3944381

Abstract

OBJECTIVE: The aim of this study was to present yearly aggregated summaries of rehabilitation outcomes at admission, discharge, and follow-up from a national sample of patients receiving inpatient medical rehabilitation for stroke, traumatic brain injury, lower extremity fracture, lower extremity joint replacement, traumatic spinal cord injury, or debility.

DESIGN: This is an analysis of secondary data from more than 300 inpatient rehabilitation facilities in the United States that contributed inpatient and follow-up data to the Uniform Data System for Medical Rehabilitation during the period January 2002 through December 2010. Aggregate variables reported include demographic information, social situation, and functional status (Functional Independence Measure instrument ratings at admission, discharge, and follow-up). Follow-up data were obtained 80-180 days after discharge through telephone interviews by trained clinical staff.

RESULTS: The final sample included 287,104 patients with follow-up information. The median time to follow-up was 95 days. Overall, more than 90% of the patients within each impairment group were living in the community at follow-up. Follow-up Functional Independence Measure total ratings were stable to slightly increased over time. Change scores (discharge to follow-up) increased in all six groups. The mean Functional Independence Measure gains from discharge to follow-up, as a percentage of mean gains from admission to discharge, varied by impairment category: 46% for spinal cord injury to 71% for lower extremity fracture. Locomotion yielded the lowest ratings at all three assessments within each of the six impairment groups.

CONCLUSIONS: The follow-up data from the national sample of patients discharged from inpatient rehabilitation indicate that gains in mean functional independence scores from both admission to discharge and discharge to follow-up gradually increased from 2002 to 2010. At follow-up, more than nine of ten patients in all six groups are living in the community.

Language: en