Effects of intensity of treatment and length of stay on rehabilitation outcomes.
The combined effects of intensity of treatment and length of stay during inpatient rehabilitation hospitalization on the outcomes of 95 traumatic brain injury patients were examined. Outcome was assessed using the Rancho Scale and three measures of functional status--physical performance, higher-level cognitive skills, and cognitively mediated physical skills. The effects of intensity of treatment and length of stay were assessed using 2 x 2 analyses of variance with repeated measures. The results showed clearly that both length of stay and intensity of treatment affect outcomes. Patients in the long length of stay group consistently made more progress across all outcome variables than patients in the short length of stay group. However, the greater progress of the long length of stay patients was from a point significantly more disabled than that of the short length of stay patients, with improvement at discharge to the point at which the groups were now equal. The effect of intensity of treatment was significant or closely approached significance for higher-level cognitive skills and Rancho Level. In the long length of stay group, the two intensity groups were initially equivalent, but at discharge the high-intensity group surpassed the low-intensity group. The practical implications of the results are discussed.
Spivack
G
G
Institute of Brain Injury Research and Training, Mediplex Rehab-Camden, NJ 08103.
Spettell
C M
CM
Ellis
D W
DW
Ross
S E
SE
D000328:Adult; D001925:Brain Damage, Chronic / Q000175:diagnosis / Q000534:rehabilitation*; D001930:Brain Injuries / Q000175:diagnosis / Q000534:rehabilitation*; D003131:Combined Modality Therapy; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D010043:Outcome and Process Assessment, Health Care; D012047:Rehabilitation Centers