Factors influencing decisions to admit patients to veterans affairs specialized rehabilitation units after lower-extremity amputation.
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.
Bates
Barbara E
BE
Veterans Affairs Medical Center Albany, NY; Department of Physical Medicine and Rehabilitation, Albany Medical College, Albany, NY, USA. barbara.bates@va.gov
Kwong
Pui L
PL
Kurichi
Jibby E
JE
Bidelspach
Douglas E
DE
Reker
Dean M
DM
Maislin
Greg
G
Xie
Dawei
D
Stineman
Margaret
M
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