title: FIM motor scores for classifying community discharge after inpatient rehabilitation for hip fracture.
abstract: OBJECTIVE
  To assess the utility of functional status in classifying patients by discharge setting after inpatient rehabilitation for hip fracture.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  A total of 1257 inpatient rehabilitation facilities in the United States.
  
  
  METHODS
  Medicare beneficiaries (N = 117,168) receiving inpatient rehabilitation for hip fracture from 2007 to 2009.
  
  
  METHODS
  Receiver operating characteristic curve analyses to assess the overall discriminatory ability of functional status scores (Functional Independence Measure [FIM] total, FIM cognition, and FIM motor) and to identify the functioning threshold that best differentiates patients by discharge setting.
  
  
  METHODS
  Discharge setting (community versus institutional).
  
  
  RESULTS
  Approximately 68% of patients were discharged to the community after inpatient rehabilitation for hip fracture. Receiver operating characteristic curve analyses indicate that discharge FIM motor ratings (area under the curve: 0.84) alone are as effective as a multivariable model (area under the curve: 0.85), including sociodemographic and clinical factors, in discriminating patients discharged to the community from those discharged to an institution. A discharge FIM motor rating of 58 yielded the best balance in sensitivity and specificity for classifying patients by discharge setting.
  
  
  CONCLUSIONS
  Discharge FIM motor ratings demonstrated good discriminatory ability for classifying discharge setting. An FIM motor rating of 58 may serve as a clinical tool to guide treatment plans and/or as additional information in complex discharge planning decisions for patients with hip fracture.
authors.affiliation: School of Physical Therapy and Center for Education and Research on Geriatrics and Gerontology, Chung Shan Medical University, Taichung, Taiwan(∗).
authors.forename: Ching-Yi
authors.initials: CY
authors.lastname: Wang
authors.affiliation: Division of Rehabilitation Sciences, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555-1137(†). Electronic address: jegraham@utmb.edu.
authors.forename: James E
authors.initials: JE
authors.lastname: Graham
authors.affiliation: Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX(‡).
authors.forename: Amol M
authors.initials: AM
authors.lastname: Karmarkar
authors.affiliation: Department of Occupational Therapy, University of Texas Medical Branch, Galveston, TX(§).
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Reistetter
authors.affiliation: School of Health Professions, University of Texas Medical Branch, Galveston, TX(‖).
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Protas
authors.affiliation: Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX(¶).
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Ottenbacher
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004185:Disability Evaluation; D004502:Education, Medical, Continuing; D005260:Female; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000534:rehabilitation* / Q000601:surgery; D006801:Humans; D057187:Independent Living / Q000706:statistics & numerical data*; D007297:Inpatients / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D009048:Motor Skills; D010351:Patient Discharge / Q000592:standards*; D012372:ROC Curve; D020127:Recovery of Function; D012047:Rehabilitation Centers / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data*; D014481:United States