TY - JOUR
T1 - Functional gains and therapy intensity during subacute rehabilitation
T2 - A study of 20 facilities
AU - Chen, Christine C.
AU - Heinemann, Allen W.
AU - Granger, Carl V.
AU - Linn, Richard T.
N1 - Funding Information:
Supported by the American Occupational Therapy Association and the National Institute on Disability and Rehabilitation Research (grant no. H133G60135).
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2002/11
Y1 - 2002/11
N2 - Objectives: To document patient, program characteristics, and therapy service provision in subacute rehabilitation across 3 types of facilities that provide subacute rehabilitation, to examine the determinants of therapy intensity, and to evaluate the contribution of rehabilitation services to functional gains. Design: A retrospective study linking administrative billing data and patients' functional assessment records. Setting: Twenty facilities part of the Uniform Data System for Medical Rehabilitation (UDSMR) subacute database Participants: A total of 1976 billing records of patients with stroke, orthopedic, and debility impairments, discharged in 1996 and 1997, were retrieved and linked with the FIM™ instrument ratings from UDSMR subacute database. Interventions: Not applicable. Main Outcomes Measures: Total therapy intensity and Rasch-transformed FIM domain gains (ie, gains in self-care, mobility, cognition). Results: Therapy intensity was mostly determined by impairment and facility type, although variances explained by the predictors were small. Patients in all 3 impairment groups made functional gains; gains were related weakly, although significantly, to therapy intensity and rehabilitation duration after controlling for other variables. Conclusions: The provision of rehabilitation therapies varied across facilities. Skilled nursing facilities with subacute rehabilitation units tended to provide more therapies than subacute units in acute or rehabilitation hospitals.
AB - Objectives: To document patient, program characteristics, and therapy service provision in subacute rehabilitation across 3 types of facilities that provide subacute rehabilitation, to examine the determinants of therapy intensity, and to evaluate the contribution of rehabilitation services to functional gains. Design: A retrospective study linking administrative billing data and patients' functional assessment records. Setting: Twenty facilities part of the Uniform Data System for Medical Rehabilitation (UDSMR) subacute database Participants: A total of 1976 billing records of patients with stroke, orthopedic, and debility impairments, discharged in 1996 and 1997, were retrieved and linked with the FIM™ instrument ratings from UDSMR subacute database. Interventions: Not applicable. Main Outcomes Measures: Total therapy intensity and Rasch-transformed FIM domain gains (ie, gains in self-care, mobility, cognition). Results: Therapy intensity was mostly determined by impairment and facility type, although variances explained by the predictors were small. Patients in all 3 impairment groups made functional gains; gains were related weakly, although significantly, to therapy intensity and rehabilitation duration after controlling for other variables. Conclusions: The provision of rehabilitation therapies varied across facilities. Skilled nursing facilities with subacute rehabilitation units tended to provide more therapies than subacute units in acute or rehabilitation hospitals.
KW - Cerebrovascular disorders
KW - Orthopedics
KW - Rehabilitation
KW - Subacute care
KW - Treatment outcome
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U2 - 10.1053/apmr.2002.35107
DO - 10.1053/apmr.2002.35107
M3 - Article
C2 - 12422318
AN - SCOPUS:0036845243
VL - 83
SP - 1514
EP - 1523
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
SN - 0003-9993
IS - 11
ER -