title: Factors influencing decisions to admit patients to veterans affairs specialized rehabilitation units after lower-extremity amputation.
abstract: Bates BE, Kwong PL, Kurichi JE, Bidelspach DE, Reker DM, Maislin G, Xie D, Stineman M. Factors influencing decisions to admit patients to Veterans Affairs specialized rehabilitation units after lower-extremity amputation.
  
  
  OBJECTIVE
  To understand patient- and facility-level characteristics that influence decisions to admit veterans to a specialized rehabilitation unit (SRU) after a lower-extremity amputation.
  
  
  METHODS
  Database study.
  
  
  METHODS
  All Veterans Affairs Medical Centers (VAMCs).
  
  
  METHODS
  Veterans with lower-extremity amputation discharged from VAMCs between October 1, 2002, and September 30, 2004.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Admission to an SRU.
  
  
  RESULTS
  There were a total of 2922 veterans with lower-extremity amputations; 616 patients were admitted to an SRU, whereas 2306 received consultative rehabilitation services only. Patients admitted to an SRU waited longer to have their first rehabilitation assessment after surgery and had middle-range physical and cognitive disabilities. Patients who received consultative rehabilitation services only tended to have greater illness burden. They were more likely to have previous amputation complication, paralysis, or renal failure and either very severe or minimal physical and cognitive disabilities.
  
  
  CONCLUSIONS
  The selection of veterans with new lower-extremity amputations for admission to an SRU appears clinically reasonable and based on the likelihood of successful outcomes.
authors.affiliation: Veterans Affairs Medical Center Albany, NY; Department of Physical Medicine and Rehabilitation, Albany Medical College, Albany, NY, USA. barbara.bates@va.gov
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Bates
authors.forename: Pui L
authors.initials: PL
authors.lastname: Kwong
authors.forename: Jibby E
authors.initials: JE
authors.lastname: Kurichi
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Bidelspach
authors.forename: Dean M
authors.initials: DM
authors.lastname: Reker
authors.forename: Greg
authors.initials: G
authors.lastname: Maislin
authors.forename: Dawei
authors.initials: D
authors.lastname: Xie
authors.forename: Margaret
authors.initials: M
authors.lastname: Stineman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000534:rehabilitation*; D003072:Cognition Disorders / Q000453:epidemiology; D003657:Decision Making; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D006742:Hospital Bed Capacity; D006787:Hospitals, Veterans; D006801:Humans; D035002:Lower Extremity / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data*; D051437:Renal Insufficiency / Q000453:epidemiology; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D015431:Weight Loss