Postacute care services use for dysvascular amputees: a population-based study of Massachusetts.
OBJECTIVE
Rehabilitation and other postacute care services utilization for persons with a lower limb amputations due to dysvascular disease is important information for physiatrists, therapists, patients, and health-policy planners. The purpose of this study was to examine rates of inpatient rehabilitation services use in a statewide population.


METHODS
Massachusetts Hospital Case Mix and Charge Data for 1997 were used to select persons with dysvascular limb amputations. Disposition locations after amputation were analyzed.


RESULTS
There were 2487 persons who incurred a lower limb amputation, with the majority being white (94%), male (58%), and elderly (69 yrs). Most had diabetes (62%) or peripheral vascular disease (51%). The most common disposition was home (33%), with 16% receiving inpatient rehabilitation after amputation. Persons with transtibial and transfemoral amputations were the most likely to receive inpatient rehabilitation, 28% and 19% respectively.


CONCLUSIONS
Sixteen percent of dysvascular amputees received inpatient rehabilitation services. This was higher than the 1997 rate for Maryland (12%) and suggests geographic differences in services utilization. Prospective studies are necessary to examine outcomes for persons receiving rehabilitation services in different care settings to define the optimal rehabilitation venue for functional restoration. Development of more specific International Classification of Diseases, Ninth Revision-Clinical Modification codes for dysvascular amputations would further research and public policy efforts.
Dillingham
Timothy R
TR
Department of Physical Medicine and Rehabilitation and the Health Policy Institute and Department of Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Pezzin
Liliana E
LE
D000368:Aged; D000671:Amputation, Surgical / Q000534:rehabilitation*; D003925:Diabetic Angiopathies / Q000534:rehabilitation* / Q000601:surgery; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D035002:Lower Extremity / Q000601:surgery; D008297:Male; D008404:Massachusetts; D016491:Peripheral Vascular Diseases / Q000534:rehabilitation* / Q000601:surgery; D012047:Rehabilitation Centers / Q000706:statistics & numerical data; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data