title: The development of an outcomes management system for acute medical rehabilitation.
abstract: In 1993, Continental Medical Systems, Inc. (CMS), a provider of comprehensive medical rehabilitation, developed the Total Outcomes and Prediction Program (TOPP) to measure and evaluate key medical rehabilitation outcomes, quality indicators, and patient satisfaction at its 37 acute rehabilitation hospitals. The broad purposes of TOPP are to manage patient treatment, improve the cost-effectiveness of care, and provide outcomes reporting for managed care and other interested parties. The challenge was to develop a system which could measure, evaluate, and report medical rehabilitation patient outcomes in a way that could be easily understood by multiple audiences, including payers, accrediting organizations, physicians, patients and families, case managers, and CMS clinical staff. Using data from the Uniform Data System for Medical Rehabilitation database, CMS created descriptive outcomes reports for each hospital and for the corporation overall, including performance statistics, outcomes report cards, and quality report cards. These initial reports, as well as updates, quarterly reports, and special ad hoc requests, provide CMS corporate and hospital staff with statistically valid and reliable information to manage the outcomes of medical rehabilitation treatment. TOPP has assisted CMS with meeting accreditation standards for outcomes management and measurement and has been used in managed care contract negotiations. Future TOPP efforts will integrate resource use data, medical acuity and outcomes from acute, subacute, and outpatient rehabilitation levels into CMS' outcomes reporting system.
authors.affiliation: Horizon/CMS Healthcare Corporation, Mechanicsburg, PA 17055, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Cohen
authors.forename: A M
authors.initials: AM
authors.lastname: Grigonis
authors.forename: M E
authors.initials: ME
authors.lastname: Topper
authors.forename: M H
authors.initials: MH
authors.lastname: Morrison
mesh_terms: D000203:Activities of Daily Living; D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D006302:Health Services Research; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D017060:Patient Satisfaction; D016730:Program Development; D012047:Rehabilitation Centers / Q000592:standards*; D017749:Total Quality Management / Q000458:organization & administration*; D017432:Unified Medical Language System; D014481:United States