title: Trends in length of stay, functional outcomes, and discharge destination stratified by disease type for inpatient rehabilitation in Singapore community hospitals from 1996 to 2005.
abstract: OBJECTIVE
  To determine the trends in length of stay (LOS), rehabilitation functional outcome, and discharge destination of patients admitted for inpatient rehabilitation from 1996 to 2005 and stratified by disease in Singapore.
  
  
  METHODS
  Retrospective national data were extracted from medical records of community-based inpatient rehabilitation admissions in Singapore from 1996 to 2005.
  
  
  METHODS
  Four community hospitals.
  
  
  METHODS
  There were 12,506 first admissions for rehabilitation; 40.6% were for stroke, 30.4% for fracture, 2.9% for lower limb (LL) joint replacement, 2.3% for LL amputation, 1.9% for cancer, 1.8% for falls, 1.6% for pneumonia, and 18.5% for other illnesses. The overall mean age ± SD was 73.2±11.5 years.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  LOS, rehabilitation outcomes (rehabilitation effectiveness [R-effectiveness], rehabilitation efficiency [R-efficiency], relative functional efficiency [Relative-FE]), and discharge destination.
  
  
  RESULTS
  The overall median LOS for all disease groups decreased by 16.2% (37 to 31d) from 1996 to 2005. The sharpest decline in LOS among the 8 disease groups was observed in the LL amputation group. The overall mean ± SD admission and discharge activities of daily living scores were 45.6±25.7 and 60.3±28.9, respectively; median R-effectiveness was 28.8%, median R-efficiency was 12.9/30d, and median Relative-FE was 27.7%/30d. From 1996 to 2005, mean R-effectiveness increased by 184% (14% to 40%), R-efficiency increased by 104% (9 to 19 units/30d), and Relative-FE increased by 145% (21% to 51%/30d). Among all inpatient admissions, most were discharged home (78.2%), 10.9% were discharged to an acute hospital, and 9.8% were discharged to nursing or sheltered homes, with no significant change during the 10-year period.
  
  
  CONCLUSIONS
  Rehabilitation outcomes of patients admitted to Singapore's community hospitals have improved between 1996 and 2005 despite a decreasing LOS. Discharge destinations have largely remained unchanged over this period.
authors: Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore.
authors: Cynthia
authors: C
authors: Chen
authors: Gerald Choon-Huat
authors: GC
authors: Koh
authors: Nasheen
authors: N
authors: Naidoo
authors: Angela
authors: A
authors: Cheong
authors: Ngan Phoon
authors: NP
authors: Fong
authors: Yaoyuan Vincent
authors: YV
authors: Tan
authors: Kin Ming
authors: KM
authors: Chan
authors: Boon Yeow
authors: BY
authors: Tan
authors: Edward
authors: E
authors: Menon
authors: Chye Hua
authors: CH
authors: Ee
authors: Kok Keng
authors: KK
authors: Lee
authors: Yee Sien
authors: YS
authors: Ng
authors: David
authors: D
authors: Koh
authors: Kee Seng
authors: KS
authors: Chia
authors: Yik Ying
authors: YY
authors: Teo
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006764:Hospitals, Community / Q000639:trends*; D006801:Humans; D007902:Length of Stay / Q000639:trends*; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000639:trends*; D026761:Physical Therapy Specialty / Q000639:trends*; D020127:Recovery of Function; D012189:Retrospective Studies; D012846:Singapore; D012959:Socioeconomic Factors