title: The Rehabilitation Complexity Scale--extended version: detection of patients with highly complex needs.
abstract: OBJECTIVE
  To describe the extended Rehabilitation Complexity Scale (RCS-E) and its factor structure, and to determine whether it provides added value over the RCS-version 2 to identify patients with highly complex rehabilitation needs.
  
  
  METHODS
  A cohort analysis of prospectively-collected routine clinical data from 331 patients with complex neurological disabilities undergoing inpatient rehabilitation in a tertiary specialist neurorehabilitation unit in the UK. RCS-E and RCS-v2 scores were recorded in parallel by the multi-disciplinary team (MDT) at fortnightly intervals, alongside the Northwick Park nursing (NPDS) and therapy (NPTDA) dependency scales, capturing nursing care and therapy interventions in staff hours/week.
  
  
  RESULTS
  Very strong correlations were found between total RCS-v2 and RCS-E scores (ρ = 0.954); the RCS-E "Care & nursing" subscale and care/nursing hours/week (ρ = 0.838, p < 0.001); and the RCS-E "Therapy" subscale and total therapy hours/week (p = 0.697, p < 0.001). The RCS-E showed better discrimination for complex therapy needs than the RCS-v2, but not for complex care/nursing needs. The RCS-E factor structure was similar to the RCS-v2, with moderate internal consistency overall, separating into two distinct dimensions ("Nursing/medical care + Equipment" and "Therapy").
  
  
  CONCLUSIONS
  The RCS-E provides an equivalent measure of complexity to the RCS-v2, but offers added value in identifying patients with highly complex therapy and equipment needs.
authors: Department of Palliative Care, Policy and Rehabilitation, King's College London School of Medicine, London, UK. lynne.turner-stokes@dial.pipex.com
authors: Lynne
authors: L
authors: Turner-Stokes
authors: Harriet
authors: H
authors: Scott
authors: Heather
authors: H
authors: Williams
authors: Richard
authors: R
authors: Siegert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003695:Delivery of Health Care / Q000458:organization & administration; D003858:Dependency, Psychological; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005163:Factor Analysis, Statistical; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009422:Nervous System Diseases / Q000534:rehabilitation*; D015588:Observer Variation; D017063:Outcome Assessment, Health Care; D005791:Patient Care / Q000592:standards*; D011446:Prospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult