Arch Phys Med Rehabil. 2014 Jan;95(1):29-38. doi: 10.1016/j.apmr.2013.07.018. Epub 2013 Aug 3.
Regional variation in stroke rehabilitation outcomes.
Reistetter TA1, Karmarkar AM2, Graham JE2, Eschbach K3, Kuo YF3, Granger CV4, Freeman J3, Ottenbacher KJ2.
Abstract
OBJECTIVE:
To examine and describe regional variation in outcomes for persons with stroke receiving inpatient medical rehabilitation.
DESIGN:
Retrospective cohort design.
SETTING:
Inpatient rehabilitation units and facilities contributing to the Uniform Data System for Medical Rehabilitation from the United States.
PARTICIPANTS:
Patients (N=143,036) with stroke discharged from inpatient rehabilitation during 2006 and 2007.
INTERVENTIONS:
Not applicable.
MAIN OUTCOME MEASURES:
Community discharge, length of stay (LOS), and discharge functional status ratings (motor, cognitive) across 10 geographic service regions defined by the Centers for Medicare and Medicaid Services (CMS).
RESULTS:
Approximately 71% of the sample was discharged to the community. After adjusting for covariates, the percentage discharged to the community varied from 79.1% in the Southwest (CMS region 9) to 59.4% in the Northeast (CMS region 2). Adjusted LOS varied by 2.1 days, with CMS region 1 having the longest LOS at 18.3 days and CMS regions 5 and 9 having the shortest at 16.2 days.
CONCLUSIONS:
Rehabilitation outcomes for persons with stroke varied across CMS regions. Substantial variation in discharge destination and LOS remained after adjusting for demographic and clinical characteristics.
Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
KEYWORDS:
CI; CMS; Centers for Medicare and Medicaid Services; Health services; IRF; IRF-PAI; Inpatient Rehabilitation Facility–Patient Assessment Instrument; LOS; OR; Quality of health care; Rehabilitation; SNF; UDSMR; Uniform Data System for Medical Rehabilitation; confidence interval; inpatient rehabilitation facility; length of stay; odds ratio; skilled nursing facility
- PMID:
- 23921200
- [PubMed - indexed for MEDLINE]
- PMCID:
- PMC4006274
- [Available on 2015/1/1]
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