Regional Variation in Stroke Rehabilitation Outcomes

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• 作者：Timothy A. Reistetter ; PhD ; OTR^a ; ^{tareiste@utmb.edu" class="auth_mail" title="E-mail the corresponding author} ; Amol M. Karmarkar ; PhD ; OTR^b ; James E. Graham ; PhD ; DC^b ; Karl Eschbach ; PhD^c ; Yong-Fang Kuo ; PhD^c ; Carl V. Granger ; MD^d ; Jean Freeman ; PhD^c ; Kenneth J. Ottenbacher ; PhD ; OTR^b
• 关键词：Health services ; Quality of health care ; Rehabilitation
• 刊名：Archives of Physical Medicine and Rehabilitation
• 出版年：2014
• 出版时间：January 2014
• 年：2014
• 卷：95
• 期：1
• 页码：29-38
• 全文大小：911 K

文摘

To examine and describe regional variation in outcomes for persons with stroke receiving inpatient medical rehabilitation.

Design

Retrospective cohort design.

Setting

Inpatient rehabilitation units and facilities contributing to the Uniform Data System for Medical Rehabilitation from the United States.

Participants

Patients (N=143,036) with stroke discharged from inpatient rehabilitation during 2006 and 2007.

Interventions

Not applicable.

Main Outcome Measures

Community discharge, length of stay (LOS), and discharge functional status ratings (motor, cognitive) across 10 geographic service regions defined by the Centers for Medicare and Medicaid Services (CMS).

Results

Approximately 71% of the sample was discharged to the community. After adjusting for covariates, the percentage discharged to the community varied from 79.1% in the Southwest (CMS region 9) to 59.4% in the Northeast (CMS region 2). Adjusted LOS varied by 2.1 days, with CMS region 1 having the longest LOS at 18.3 days and CMS regions 5 and 9 having the shortest at 16.2 days.

Conclusions

Rehabilitation outcomes for persons with stroke varied across CMS regions. Substantial variation in discharge destination and LOS remained after adjusting for demographic and clinical characteristics.