Functional gains and therapy intensity during subacute rehabilitation: a study of 20 facilities.
OBJECTIVE
To document patient, program characteristics, and therapy service provision in subacute rehabilitation across 3 types of facilities that provide subacute rehabilitation, to examine the determinants of therapy intensity, and to evaluate the contribution of rehabilitation services to functional gains.


METHODS
A retrospective study linking administrative billing data and patients' functional assessment records.


METHODS
Twenty facilities part of the Uniform Data System for Medical Rehabilitation (UDSMR) subacute database


METHODS
A total of 1976 billing records of patients with stroke, orthopedic, and debility impairments, discharged in 1996 and 1997, were retrieved and linked with the FIM trade mark instrument ratings from UDSMR subacute database.


METHODS
Not applicable.


METHODS
Total therapy intensity and Rasch-transformed FIM domain gains (ie, gains in self-care, mobility, cognition).


RESULTS
Therapy intensity was mostly determined by impairment and facility type, although variances explained by the predictors were small. Patients in all 3 impairment groups made functional gains; gains were related weakly, although significantly, to therapy intensity and rehabilitation duration after controlling for other variables.


CONCLUSIONS
The provision of rehabilitation therapies varied across facilities. Skilled nursing facilities with subacute rehabilitation units tended to provide more therapies than subacute units in acute or rehabilitation hospitals.
Chen
Christine C
CC
Rehabilitation Institute of Chicago, 345 E. Superior Street, Chicago, IL 60611, USA. c-chen1@northwestern.edu
Heinemann
Allen W
AW
Granger
Carl V
CV
Linn
Richard T
RT
D000203:Activities of Daily Living; D000368:Aged; D019643:Arthroplasty, Replacement / Q000534:rehabilitation; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D006233:Persons with Disabilities / Q000534:rehabilitation; D005260:Female; D015577:Geriatric Assessment; D006302:Health Services Research; D006620:Hip Fractures / Q000534:rehabilitation; D006769:Hospitals, General / Q000592:standards*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012046:Rehabilitation / Q000379:methods*; D012047:Rehabilitation Centers / Q000592:standards*; D012189:Retrospective Studies; D012866:Skilled Nursing Facilities / Q000592:standards*; D000071939:Stroke Rehabilitation; D019467:Subacute Care / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States