Feasibility of computerized adaptive testing for collection of patient-reported outcomes after inpatient rehabilitation.
OBJECTIVE
To evaluate the feasibility of computer adaptive testing (CAT) using an Internet or telephone interface to collect patient-reported outcomes after inpatient rehabilitation and to examine patient characteristics associated with completion of the CAT-administered measure and mode of administration.


METHODS
Prospective cohort study of patients contacted approximately 4 weeks after discharge from inpatient rehabilitation. Patients selected an Internet or telephone interface.


METHODS
Rehabilitation hospital.


METHODS
Patients (N=674) with diagnoses of neurologic, orthopedic, or medically complex conditions.


METHODS
None.


METHODS
CAT version of the Community Participation Indicators (CAT-CPI).


RESULTS
From an eligible pool of 3221 patients, 674 (21%) agreed to complete the CAT-CPI. Patients who agreed to complete the CAT-CPI were younger and reported slightly higher satisfaction with overall care than those who did not participate. Among these patients, 231 (34%) actually completed the CAT-CPI; 141 (61%) selected telephone administration, and 90 (39%) selected Internet administration. Decreased odds of completing the CAT-CPI were associated with black and other race; stroke, brain injury, or orthopedic and other impairments; and being a Medicaid beneficiary, whereas increased odds of completing the CAT-CPI were associated with longer length of stay and higher discharge FIM cognition measure. Decreased odds of choosing Internet administration were associated with younger age, retirement status, and being a woman, whereas increased odds of choosing Internet administration were associated with higher discharge FIM motor measure.


CONCLUSIONS
CAT administration by Internet and telephone has limited feasibility for collecting postrehabilitation outcomes for most rehabilitation patients, but it is feasible for a subset of patients. Providing alternative ways of answering questions helps assure that a larger proportion of patients will respond.
Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL; Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL. Electronic address: wwong@ric.org.
Alex W K
AW
Wong
Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL; Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL.
Allen W
AW
Heinemann
Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL.
Ana
A
Miskovic
Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL.
Patrick
P
Semik
Department of Outcome Measurement Systems and Analysis, Rehabilitation Institute of Chicago, Chicago, IL.
Thomas M
TM
Snyder
D000203:Activities of Daily Living; D000222:Adaptation, Physiological; D000368:Aged; D003199:Computer Systems; D005163:Factor Analysis, Statistical; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients; D020407:Internet; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010351:Patient Discharge; D011446:Prospective Studies; D012046:Rehabilitation / Q000592:standards*; D019467:Subacute Care / Q000592:standards*; D011795:Surveys and Questionnaires
Outcome assessment (health care); Rehabilitation