title: Rehabilitation outcomes among burn injury patients with a second admission to an inpatient rehabilitation facility.
abstract: BACKGROUND
  Burn survivors tend to have complex medical issues requiring rehabilitation to improve overall function and quality of life. A subset of burn patients treated in inpatient rehabilitation facilities (IRFs) may require more than 1 rehabilitation stay for the same injury.
  
  
  OBJECTIVE
  To compare the rehabilitation outcomes among burn patients admitted to an IRF who were discharged to acute care and then readmitted to an IRF with burn patients admitted to an IRF only 1 time.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Inpatient rehabilitation facilities.
  
  
  METHODS
  Burn injury patients aged 18 years or more who were admitted to IRFs between 2002 and 2011.
  
  
  METHODS
  We performed a secondary analysis of data from Uniform Data System for Medical Rehabilitation, a national data repository. Outcomes of the repeaters' second stay (n = 188) were compared to the nonrepeaters' first and only stay (n = 6,855), using linear regression and logistic regression to determine whether repeater status was associated with rehabilitation outcomes.
  
  
  METHODS
  Functional status (using the Functional Independence Measure [FIM] instrument) at admission, discharge and change, length of stay, FIM efficiency (total FIM points gained per day), and discharge disposition.
  
  
  RESULTS
  Repeater status was inversely associated with discharge FIM total (coefficient = -3.42, 95% confidence interval = -5.76, -1.07) and FIM change (coefficient = -4.05, 95% CI = -6.34, -1.75) in linear regression models. No other significant differences were found, and those differences in discharge FIM total and FIM change were small.
  
  
  CONCLUSIONS
  Differences found in rehabilitation outcomes between the repeater and nonrepeater groups were small and may not reflect clinically meaningful differences. Burn injury patients who required a second IRF admission had rehabilitation outcomes similar to those of burn injury patients who did not require a second IRF admission, emphasizing the value of inpatient rehabilitation for burn injury IRF readmissions.
authors.affiliation: Uniform Data System for Medical Rehabilitation, 270 Northpointe Parkway, Amherst, NY 14228; and Health Department, State University of New York at Cortland, Cortland, NY∗. Electronic address: margaret.divita@cortland.edu.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: DiVita
authors.affiliation: Uniform Data System for Medical Rehabilitation, Amherst, NY(†).
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Mix
authors.affiliation: Department of Physical Medicine and Rehabilitation Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA(‡).
authors.forename: Richard
authors.initials: R
authors.lastname: Goldstein
authors.affiliation: Department of Physical Medicine and Rehabilitation Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA(§).
authors.forename: Paul
authors.initials: P
authors.lastname: Gerrard
authors.affiliation: Uniform Data System for Medical Rehabilitation, Amherst, NY; and Health Care Studies Department, Daemen College, Amherst, NY(‖).
authors.forename: Paulette
authors.initials: P
authors.lastname: Niewczyk
authors.affiliation: Sumner Redstone Burn Center, Surgical Services Massachusetts General Hospital, Harvard Medical School, Boston, MA; and Shriners Hospitals for Children-Boston, Boston, MA(¶).
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Ryan
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center at Dallas, Dallas, TX(#).
authors.forename: Karen
authors.initials: K
authors.lastname: Kowalske
authors.affiliation: Department of Physical Medicine and Rehabilitation Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA∗∗
authors.forename: Ross
authors.initials: R
authors.lastname: Zafonte
authors.affiliation: Department of Physical Medicine and Rehabilitation Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA; and Shriners Hospitals for Children-Boston, Boston, MA(††).
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Schneider
mesh_terms: D002056:Burns / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D010359:Patient Readmission / Q000639:trends*; D011788:Quality of Life; D020127:Recovery of Function; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D012189:Retrospective Studies