Measuring patient-reported outcomes after discharge from inpatient rehabilitation settings.
OBJECTIVE
To examine the sensitivity of the Short Form Activity Measure for Post-Acute Care (AM-PAC) in comparison to the Functional Independence Measure (FIM) across a 12-month period after discharge from rehabilitation hospital.


METHODS
Prospective longitudinal study. Patients were recruited while receiving inpatient services from facilities in the north-east USA and interviewed 1, 6 and 12 months thereafter.


METHODS
Convenience sample of 516 patients at baseline (65% retention at the final follow-up) receiving rehabilitation services for neurological, lower extremity orthopedic, or complex medical conditions. Mean age 68.3 years; 47% male.


METHODS
AM-PAC Physical and Movement, Personal Care and Instrumental, and Applied Cognitive Activity scales; FIM Motor and Cognitive scales.


RESULTS
All 3 AM-PAC scales were sensitive to both positive and negative change across the follow-up period. Standardized response means for the AM-PAC were consistently larger than for the FIM across patient and severity groups. A greater percentage of patients showed positive change that exceeded the minimal detectable change on the AM-PAC than on the FIM both 6- and 12-month follow-ups.


CONCLUSIONS
The short-form AM-PAC scales are more sensitive measures of change in functional activity performance over time in the general population of persons who receive inpatient rehabilitation services compared to the FIM. Thus, the AM-PAC offers a short, comprehensive, and sensitive measure of positive and/or negative change in patients' ability to perform important activities of daily life.
Coster
Wendy J
WJ
Department of Occupational Therapy and Rehabilitation Counseling, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, USA. wjcoster@bu.edu
Haley
Stephen M
SM
Jette
Alan M
AM
D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010351:Patient Discharge; D011446:Prospective Studies; D012046:Rehabilitation / Q000592:standards*; D012047:Rehabilitation Centers / Q000592:standards; D020377:Self Efficacy; D012680:Sensitivity and Specificity; D018434:Sickness Impact Profile