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The Uniform Data System for Medical Rehabilitation: Report of Patients with Stroke Discharged from Comprehensive Medical Programs in 2000-2007

Granger, Carl V. MD; Markello, Samuel J. PhD; Graham, James E. PhD, DC; Deutsch, Anne RN, PhD, CRRN; Ottenbacher, Kenneth J. PhD, OTR

American Journal of Physical Medicine & Rehabilitation: December 2009 - Volume 88 - Issue 12 - pp 961-972
doi: 10.1097/PHM.0b013e3181c1ec38
Original Research Article: Outcomes

Granger CV, Markello SJ, Graham JE, Deutsch A, Ottenbacher KJ: The Uniform Data System for Medical Rehabilitation: report of patients with stroke discharged from Comprehensive Medical Programs in 2000-2007.

Objective: To provide benchmarking information for a large national sample of patients receiving inpatient rehabilitation after a stroke.

Design: Analysis of secondary data from 893 medical rehabilitation facilities located in the United States and contributing information to the Uniform Data System for Medical Rehabilitation from 2000 to 2007.

Results: Variables analyzed included demographic information (age, sex, marital status, race/ethnicity, prehospital living setting, and discharge setting), hospitalization information (length of stay, program interruptions, payer, event onset date, rehabilitation impairment group, International Classification of Diseases-9 codes for the admitting diagnosis, and comorbidities), and functional status information (FIM® instrument [“FIM”] ratings at admission and discharge, FIM efficiency, and FIM gain). Descriptive statistics revealed that the length of stay decreased from a mean of 19.6 (±12.8) days to 16.5 (±9.8) days during the 8-yr study period. FIM instrument admission and discharge ratings also decreased. Mean admission ratings decreased from 62.5 (±20.1) to 55.1 (±19.3), and mean discharge ratings decreased from 86.4 (±23.6) to 79.8 (±24.0). FIM change remained relatively stable; the mean for the entire sample was 23.9 (±14.8). The percent of persons discharged to the community ranged from 75.8% in 2000 to 69.3% in 2007. All results are likely affected by changes in the definition for program interruption and procedures for FIM data collection.

Conclusion: Uniform Data System for Medical Rehabilitation data from persons with stroke receiving rehabilitation from 2000 to 2007 indicate patients are showing improvement in functional independence during their rehabilitation stay, and a large percentage are discharged to community settings.

From the Uniform Data System for Medical Rehabilitation (CVG, SM), A division of UB Foundation Activities, Inc., Buffalo, New York; Division of Rehabilitation Sciences (JEG, KJO), University of Texas Medical Branch, Galveston, Texas; and Rehabilitation Institute of Chicago and Department of Physical Medicine and Rehabilitation (AD), Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

All correspondence and requests for reprints should be addressed to K. Ottenbacher, PhD, OTR, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-1137.

Supported in part by a grant H133G080163 from the National Institute on Disability and Rehabilitation Research, U.S. Department of Education (to KJO).

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2009 Lippincott Williams & Wilkins, Inc.