The self-reported functional measure: Predictive validity for health care utilization in multiple sclerosis and spinal cord injury.
OBJECTIVE
To examine the predictive validity of the Self-Reported Functional Measure (SRFM), a new measure derived from the FIMtrade mark instrument, for health care utilization in multiple sclerosis (MS) and spinal cord injury (SCI).


METHODS
Prospective cohort study using a mailed survey in 1995 and administrative records from 1996 and 1997.


METHODS
Veterans Health Administration hospitals and outpatient clinics.


METHODS
A total of 6361 veterans with SCI and 1789 veterans with MS.


METHODS
SRFM score was compared with subsequent outpatient visits, hospitalizations, hospital lengths of stay (LOSs), and residence peri-hospitalization. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for these variables.


RESULTS
A total of 3836 subjects (47.6%) were hospitalized during 1996-1997, and all but 874 (10.7%) had 1 or more outpatient visits. SRFM score predicted inpatient, but not outpatient health care utilization. Persons in the lowest SRFM quartile were over 90% (OR = 1.91, 95% CI = 1.71-2.13) more likely to be hospitalized compared with those in the highest SRFM quartile; also, they were over 2 times (OR = 2.18, 95% CI = 1.85-2.57) more likely to have a LOS greater than 7 days, were over 2 times (OR = 2.41, 95% CI = 1.62-3.58) more likely to die in hospital, and were nearly 3 times (OR = 2.86, 95% CI = 2.00-4.08) more likely to be discharged to an institution.


CONCLUSIONS
SRFM had excellent predictive validity for hospitalization, LOS, and discharge destination among patients with MS or SCI.
Hoenig
H
H
Physical Medical and Rehabilitation Service, Health Services Research and Development Field Program, Durham Veterans Administration Medical Center, Durham, NC, USA. hoeni001@acpub.duke.edu
Hoff
J
J
McIntyre
L
L
Branch
L G
LG
D016001:Confidence Intervals; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D004185:Disability Evaluation; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000401:mortality / Q000534:rehabilitation*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000401:mortality / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology