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The Uniform Data System for Medical Rehabilitation: Report of Patients with Traumatic Spinal Cord Injury Discharged from Rehabilitation Programs in 2002–2010

Granger, Carl V. MD; Karmarkar, Amol M. PhD, OTR; Graham, James E. PhD, DC; Deutsch, Anne RN, PhD, CRRN; Niewczyk, Paulette PhD, MPH; DiVita, Margaret A. MS; Ottenbacher, Kenneth J. PhD, OTR

American Journal of Physical Medicine & Rehabilitation: April 2012 - Volume 91 - Issue 4 - p 289–299
doi: 10.1097/PHM.0b013e31824ad2fd
Original Research Articles

Objective: This study aimed to provide benchmarking information from a large national sample of patients receiving inpatient rehabilitation after a traumatic spinal cord injury.

Design: This was an analysis of secondary data from 891 inpatient medical rehabilitation facilities in the United States that contributed traumatic spinal cord injury data to the Uniform Data System for Medical Rehabilitation from January 2002 to December 2010. Variables analyzed included demographic information (age, sex, marital status, race/ethnicity, prehospital living setting, discharge setting), hospitalization information (length of stay, program interruptions, payer, onset date, rehabilitation impairment group, International Classification of Diseases 9 codes for admitting diagnosis, co-morbidities), and functional status (Functional Independence Measure [FIM] instrument ratings at admission and discharge, FIM efficiency, FIM gain).

Results: The final sample included 47,153 patients with traumatic spinal cord injury. Overall, the mean length of stay was 26.2 ± 23.2 days: yearly means ranged from 29.7 ± 25.4 in 2002 to 22.9 ± 18.9 in 2009. FIM total admission and discharge ratings also declined during the 8-yr study period; admission decreased from 60.5 ± 17.4 to 55.9 ± 16.3; discharge decreased from 86.1 ± 23.8 to 82.4 ± 23.4. Rehabilitation efficiency (FIM gain per day) remained relatively stable over time (1.6 ± 1.7 points per day). The percentage of all patients discharged to the community ranged from 75.8% to 71.5% per year. Wheelchair users stayed in rehabilitation longer than did persons who could walk (34.6 ± 217.4 vs. 17.4 ± 14.1 days) and also experienced less functional improvement (21.6 ± 15.8 vs. 29.6 ± 16.3 FIM points).

Conclusions: National data from persons with traumatic spinal cord injury in 2002–2010 indicate that lengths of stay declined, but efficiency in functional independence was stable to slightly increased. More than 70% of patients were consistently discharged to community settings after inpatient rehabilitation.

From the Uniform Data System for Medical Rehabilitation, UB Foundation Activities Inc., Buffalo, NY (CVG, PN, MAD); Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston (AMK, JEG, KJO); and Rehabilitation Institute of Chicago and Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine and Institute for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL (AD).

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

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. Supported by Department of Education, National Institute on Disability and Rehabilitation Research grants H133G080163 (K.J. Ottenbacher, PI), H133F090030 (J.E. Graham), and H133N060014 (A. Deutsch) However, those contents do not necessarily represent the policy of the Department of Education, and endorsement by the Federal Government should not be assumed.

The FIM instrument is a registered trademark of the Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities Inc.

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.