title: A 10-year perspective on the patients referred to a geriatric rehabilitation complex: the influence of managed care.
abstract: OBJECTIVE
  In the past 10 years, HMOs have used managed care to reduce patients referrals for rehabilitation in our Geriatric Rehabilitation Complex (GRC).
  
  
  METHODS
  This study compares data regarding patients referred for rehabilitation for 4 months in 1998 with data from a similar study we performed in 1989.
  
  
  METHODS
  The GRC, which is part of a 396-bed geriatric hospital, includes a 36-bed ward complemented by departments of physical and occupational therapy, a speech therapy unit, and a rehabilitation psychologist. It is supported by modern rehabilitation equipment and facilities and is staffed by experienced, highly qualified academic personnel.
  
  
  RESULTS
  The overall number of patients referred for rehabilitation decreased by 36% during this period. However, the average age of patients is higher, the number of patients with Recc. Stroke dominates, and length of stay was reduced by 20%.
  
  
  CONCLUSIONS
  Although the rehabilitation needs of older people are increasing, fewer patients are referred to our GRC. Those who are referred are older, and their condition is more complicated; nevertheless, their length of stay has also been reduced. These are the results of HMO policies to refer older patients to new "rehabilitation settings" that charge lower prices while offering services of still unproved quality. As geriatricians, it is our duty to prevent cost considerations from overtaking the need to maximizing functional recovery.
authors.affiliation: Geriatric Medical Center, Shmuel Harofe Hospital, affiliated to the Sackler School of Medicine, Tel-Aviv University, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Leibovitz
authors.forename: E
authors.initials: E
authors.lastname: Lubart
authors.forename: H
authors.initials: H
authors.lastname: Rabinovich
authors.forename: L
authors.initials: L
authors.lastname: Baumohl
authors.forename: N
authors.initials: N
authors.lastname: Platinovich
authors.forename: B
authors.initials: B
authors.lastname: Habot