title: Effect of shortened length of stay on functional and educational outcome after pediatric rehabilitation.
abstract: OBJECTIVE
  The purpose of this study was to assess changes in the length of stay and its effect on effectiveness and return to school in an inpatient pediatric rehabilitation unit during a 5-yr period from fiscal year 1997 through 2001.
  
  
  METHODS
  We reviewed prospectively collected data for a cohort of 321 children during fiscal years 1997-2001.
  
  
  RESULTS
  Length of stay was significantly shortened, with mean lengths of stay of 58.9, 43.5, 30.7, 40.9, and 24.0 days in years 1997 through 2001, respectively. Change in length of stay remained significantly decreased after adjusting for age, sex, admission diagnosis, admission severity, and type of health insurance. There was no difference in mean change in effectiveness measured by change in admission and discharge WeeFIM ratings. There were significant differences across years in the educational placement of children at discharge, with a declining trend in the proportion of children discharged to classroom-based educational services.
  
  
  CONCLUSIONS
  There was a reduction in inpatient length of stay during a 5-yr period for children in this pediatric rehabilitation setting. During this time, there was no change in the effectiveness of rehabilitation as measured by functional outcome. However, using return to a classroom setting as a marker of reintegration into routine activities, fewer children returned to a similar level of community participation.
authors.affiliation: University of Virginia, Kluge Children's Rehabilitation Center and Research Institute, 2270 Ivy Road, Charlottesville, VA 22903, USA.
authors.forename: Sydney A
authors.initials: SA
authors.lastname: Rice
authors.forename: Janet
authors.initials: J
authors.lastname: Allaire
authors.forename: Kevin
authors.initials: K
authors.lastname: Elgin
authors.forename: Walter
authors.initials: W
authors.lastname: Farrell
authors.forename: Mark
authors.initials: M
authors.lastname: Conaway
authors.forename: James A
authors.initials: JA
authors.lastname: Blackman
mesh_terms: D000293:Adolescent; D002648:Child; D016001:Confidence Intervals; D004493:Education; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007348:Insurance, Health; D007902:Length of Stay; D008297:Male; D011446:Prospective Studies; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000145:classification / Q000534:rehabilitation*