The Northwick Park Care Needs Assessment (NPCNA): a measure of community care needs: sensitivity to change during rehabilitation.
OBJECTIVE
To determine whether the Northwick Park Care Needs Assessment (NPCNA) is sensitive to change occurring during rehabilitation and provides a reliable estimate of care needs in the community, and to compare the NPCNA with the Functional Independence Measure (FIM).


METHODS
Prospective cohort study.


METHODS
Postacute neurorehabilitation unit for young patients with complex disabilities.


METHODS
Thirty-nine consecutive patients with brain injury admitted over six months.


METHODS
The NPCNA was assessed on admission and at discharge. Two subsets of patients were also assessed (a) at three-month follow-up in the community (n = 15), and (b) both in hospital and in the home environments at the discharge time point (n = 28). Data were compared with FIM scores on admission and discharge.


RESULTS
The median total weekly care hours fell from 52 hours (interquartile range (IQR) 25-66) on admission, to 17 hours (IQR 6-46) on discharge (p<0.001). There was a median reduction of approximate weekly cost of care from 600 pound sterling (IQR 224-824 pound sterling) to 168 pound sterling (IQR 56-280 pound sterling) (p<0.001). These benefits were sustained at follow-up, and the NPCNA measured in hospital at discharge gave a good estimation of the care hours and weekly cost of care in the community at three months after discharge. There was no significant correlation with FIM gain.


CONCLUSIONS
In this study the NPCNA, measured while the patient was still in hospital, gave a good estimation of care needs in the community and was sensitive to change occurring during rehabilitation in patients with severe complex disabilities.
Nyein
K
K
Regional Rehabilitation Unit, Northwick Park, Middlesex, UK.
Turner-Stokes
L
L
Robinson
I
I
D000203:Activities of Daily Living; D001930:Brain Injuries / Q000191:economics / Q000534:rehabilitation*; D003153:Community Health Services / Q000191:economics; D003365:Costs and Cost Analysis; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D012046:Rehabilitation / Q000191:economics; D013997:Time Factors; D016896:Treatment Outcome