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The Uniform Data System for Medical Rehabilitation: Report of Follow-up Information on Patients Discharged from Inpatient Rehabilitation Programs in 20022010

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

American Journal of Physical Medicine & Rehabilitation: March 2014 - Volume 93 - Issue 3 - p 231–244
doi: 10.1097/PHM.0b013e3182a92c58
Original Research Articles

Objective: The aim of this study was to present yearly aggregated summaries of rehabilitation outcomes at admission, discharge, and follow-up from a national sample of patients receiving inpatient medical rehabilitation for stroke, traumatic brain injury, lower extremity fracture, lower extremity joint replacement, traumatic spinal cord injury, or debility.

Design: This is an analysis of secondary data from more than 300 inpatient rehabilitation facilities in the United States that contributed inpatient and follow-up data to the Uniform Data System for Medical Rehabilitation during the period January 2002 through December 2010. Aggregate variables reported include demographic information, social situation, and functional status (Functional Independence Measure instrument ratings at admission, discharge, and follow-up). Follow-up data were obtained 80–180 days after discharge through telephone interviews by trained clinical staff.

Results: The final sample included 287,104 patients with follow-up information. The median time to follow-up was 95 days. Overall, more than 90% of the patients within each impairment group were living in the community at follow-up. Follow-up Functional Independence Measure total ratings were stable to slightly increased over time. Change scores (discharge to follow-up) increased in all six groups. The mean Functional Independence Measure gains from discharge to follow-up, as a percentage of mean gains from admission to discharge, varied by impairment category: 46% for spinal cord injury to 71% for lower extremity fracture. Locomotion yielded the lowest ratings at all three assessments within each of the six impairment groups.

Conclusions: The follow-up data from the national sample of patients discharged from inpatient rehabilitation indicate that gains in mean functional independence scores from both admission to discharge and discharge to follow-up gradually increased from 2002 to 2010. At follow-up, more than nine of ten patients in all six groups are living in the community.

From the Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston (JEG, AMK, KJO); Uniform Data System for Medical Rehabilitation, Buffalo, New York (CVG, PN, MAD); Rehabilitation Institute of Chicago, Illinois (AD); Department of Physical Medicine and Rehabilitation and Institute for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (AD); and RTI International, Washington, DC (AD).

All correspondence and requests for reprints should be addressed to Kenneth J. Ottenbacher, PhD, OTR, Division of Rehabilitation Sciences, University of Texas Medical Branch, 301 University Blvd, Galveston, TX.

The Uniform Data System for Medical Rehabilitation is a division of UB Foundation Activities, Inc.

Supported by grants from the Department of Education; the National Institute on Disability and Rehabilitation Research (H133G080163 [to K.J.O.] and H133N060014 [to A.D.]); and the National Institutes of Health, National Center for Medical Rehabilitation Research (R24 HD065702 [to K.J.O., J.E.G., A.M.K.]).

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

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.

© 2014 by Lippincott Williams & Wilkins