title: Inpatient rehabilitation utilization for Medicare beneficiaries with multiple sclerosis.
abstract: OBJECTIVE
  To explore the use of inpatient rehabilitation facility services and levels of impairment for Medicare beneficiaries with multiple sclerosis (MS) by comparing differences in service utilization and clinical characteristics between Medicare beneficiaries with MS to the overall Medicare population.
  
  
  METHODS
  Medicare beneficiaries with MS were identified using Medicare claims data. Claims and assessment data were analyzed to compare outcomes for beneficiaries with MS who used inpatient rehabilitation compared with a random sample of Medicare beneficiaries without MS.
  
  
  METHODS
  Inpatient rehabilitation facilities.
  
  
  METHODS
  Medicare beneficiaries with a diagnosis of MS who received inpatient rehabilitation during the 2007 calendar year (n=4669) and a random sample of Medicare beneficiaries without MS (n=14,397).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Change in functional impairment levels between admission and discharge to inpatient rehabilitation and length of stay.
  
  
  RESULTS
  There were several differences in beneficiary characteristics between the 2 groups. Beneficiaries with MS had lower change in functional levels (-3.3 points on the FIM) and longer length of stay (0.4d).
  
  
  CONCLUSIONS
  While beneficiaries with MS account for a small proportion of the Medicare population, the benefit is important to those who qualify for Medicare coverage. This study illustrates the differences between the subpopulation of beneficiaries with MS and other Medicare beneficiaries. The findings show that populations with MS had less functional improvement than other Medicare populations using the inpatient rehabilitation setting. Higher rates of depression within the MS Medicare population was a secondary finding that presents another important consideration for rehabilitation service needs for this group.
authors.affiliation: Aging Disability and Long-Term Care, RTI International, Waltham, MA 02451-1623, USA. mmorley@rti.org
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Morley
authors.forename: Laura A
authors.initials: LA
authors.lastname: Coots
authors.forename: Angela L
authors.initials: AL
authors.lastname: Forgues
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Gage
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data*; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000534:rehabilitation*; D015995:Prevalence; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States