Outcomes of inpatient rehabilitation for older adults with debility.
OBJECTIVE
To determine the functional outcomes and discharge setting of older patients receiving inpatient rehabilitation for debility (ICD-9-CM, 799.3).


METHODS
Retrospective cohort study of 63,171 individuals >or= 65 yrs old with a primary (23%) or comorbid (77%) debility diagnosis from the Uniform Data System for Medical Rehabilitation (UDSMR) database for 2002-2003.


RESULTS
Patients with a primary diagnosis of debility (PDD) had a lower mean rehabilitation efficiency score (functional change per day) as compared with the rest of the subjects (1.7 vs. 1.9, P<0.001), including those with a Centers for Medicare & Medicaid Services (CMS) 75% rule primary diagnosis (1.8, P<0.001). The PDD group was less likely to be discharged home (68% vs. 73%, P<0.001) and more likely to be discharged to a hospital (13% vs. 11%, P<0.001).


CONCLUSIONS
From a clinical perspective, the functional recovery of older patients with debility is essentially the same, regardless of whether this is a primary or comorbid diagnosis. Their functional improvement is also comparable with that reported for other CMS 75% rule diagnoses, although the debility patients are less likely to be discharged home. More than 10% of these patients were discharged to acute hospital settings. Further research is warranted to identify the most appropriate rehabilitation setting for patients with debility.
Kortebein
Patrick
P
Department of Physical Medicine and Rehabilitation, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA.
Bopp
Melinda M
MM
Granger
Carl V
CV
Sullivan
Dennis H
DH
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D005853:Geriatrics; D006305:Health Status Indicators; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D018908:Muscle Weakness / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D012042:Registries; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D016896:Treatment Outcome