title: Comparison of Rehabilitation Outcomes for Long Term Neurological Conditions: A Cohort Analysis of the Australian Rehabilitation Outcomes Centre Dataset for Adults of Working Age.
abstract: OBJECTIVE
  To describe and compare outcomes from in-patient rehabilitation (IPR) in working-aged adults across different groups of long-term neurological conditions, as defined by the UK National Service Framework.
  
  
  METHODS
  Analysis of a large Australian prospectively collected dataset for completed IPR episodes (n = 28,596) from 2003-2012.
  
  
  METHODS
  De-identified data for adults (16-65 years) with specified neurological impairment codes were extracted, cleaned and divided into 'Sudden-onset' conditions: (Stroke (n = 12527), brain injury (n = 7565), spinal cord injury (SCI) (n = 3753), Guillain-Barré syndrome (GBS) (n = 805)) and 'Progressive/stable' conditions (Progressive (n = 3750) and Cerebral palsy (n = 196)). Key outcomes included Functional Independence Measure (FIM) scores, length of stay (LOS), and discharge destination.
  
  
  RESULTS
  Mean LOS ranged from 21-57 days with significant group differences in gender, source of admission and discharge destination. All six groups showed significant change (p<0.001) between admission and discharge that was likely to be clinically important across a range of items. Significant between-group differences were observed for FIM Motor and Cognitive change scores (Kruskal-Wallis p<0.001), and item-by-item analysis confirmed distinct patterns for each of the six groups. SCI and GBS patients were generally at the ceiling of the cognitive subscale. The 'Progressive/stable' conditions made smaller improvements in FIM score than the 'Sudden-onset conditions', but also had shorter LOS.
  
  
  CONCLUSIONS
  All groups made gains in independence during admission, although pattern of change varied between conditions, and ceiling effects were observed in the FIM-cognitive subscale. Relative cost-efficiency between groups can only be indirectly inferred. Limitations of the current dataset are discussed, together with opportunities for expansion and further development.
authors.affiliation: King's College London, School of Medicine, Department of Palliative Care, Policy and Rehabilitation, London, United Kingdom.
authors.forename: Lynne
authors.initials: L
authors.lastname: Turner-Stokes
authors.affiliation: King's College London, School of Medicine, Department of Palliative Care, Policy and Rehabilitation, London, United Kingdom.
authors.forename: Roxana
authors.initials: R
authors.lastname: Vanderstay
authors.affiliation: University of Wollongong, Australasian Rehabilitation Outcomes Centre / Australian Health Services Research Institute, Wollongong, Australia.
authors.forename: Tara
authors.initials: T
authors.lastname: Stevermuer
authors.affiliation: University of Wollongong, Australasian Rehabilitation Outcomes Centre / Australian Health Services Research Institute, Wollongong, Australia.
authors.forename: Frances
authors.initials: F
authors.lastname: Simmonds
authors.affiliation: University of Melbourne and Royal Melbourne Hospital, Department of Rehabilitation, Melbourne, Australia.
authors.forename: Fary
authors.initials: F
authors.lastname: Khan
authors.affiliation: University of Wollongong, Australasian Rehabilitation Outcomes Centre / Australian Health Services Research Institute, Wollongong, Australia.
authors.forename: Kathy
authors.initials: K
authors.lastname: Eagar
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D001930:Brain Injuries / Q000534:rehabilitation; D002547:Cerebral Palsy / Q000534:rehabilitation; D005260:Female; D020275:Guillain-Barre Syndrome / Q000534:rehabilitation; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000534:rehabilitation*; D011446:Prospective Studies; D012047:Rehabilitation Centers / Q000706:statistics & numerical data; D013119:Spinal Cord Injuries / Q000534:rehabilitation; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D055815:Young Adult