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Satisfaction with Medical Rehabilitation in Patients with Cerebrovascular Impairment

Ottenbacher, Kenneth J. PhD; Gonzales, Vera A. PhD; Smith, Pam M. DNS, RN; Illig, Sandra B. MS, RN; Fiedler, Roger C. PhD; Granger, Carl V. MD

American Journal of Physical Medicine & Rehabilitation: December 2001 - Volume 80 - Issue 12 - p 876-884
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Ottenbacher KJ, Gonzales VA, Smith PM, Illig SB, Fiedler RC, Granger CV: Satisfaction with medical rehabilitation in patients with cerebrovascular impairment. Am J Phys Med Rehabil 2001;80:876–884.

Objective Overall satisfaction has important social and economic implications for patients who have received inpatient medical rehabilitation. We conducted this study to examine the overall satisfaction level at 3- to 6-mo follow-up for inpatients with cerebrovascular impairments discharged from medical rehabilitation.

Design The study was retrospective using information from a national database representative of medical rehabilitation patients across the United States. Information submitted in 1997 and 1998 to the Uniform Data System for Medical Rehabilitation by 177 hospital and rehabilitation facilities from 40 states was examined. The final sample included 8,900 patient records. The main outcome measure was the level of satisfaction with medical rehabilitation at 80–180 days postdischarge follow-up.

Results A logistic regression model including ten independent variables was used to predict satisfied vs. dissatisfied at follow-up. Three statistically significant variables were included in the final model and correctly classified 95.1% of the patients. Higher FIM™ instrument discharge scores were associated with increased satisfaction. Further analysis of the FIM instrument subscales indicated that higher ratings in transfers, social cognition, and locomotion were significantly associated with increased satisfaction.

Conclusion We identified several functional variables associated with increased satisfaction after medical rehabilitation in persons with stroke. The ability to objectively assess patient satisfaction is important as consumer-based outcome measures are integrated in accreditation and healthcare evaluation.

From the University of Texas Medical Branch (KJO, VAG), Galveston, Texas; National FollowUp Services (PMS, SBI), Buffalo, New York; and the Center for Functional Assessment Research (RCF, CVG), Department of Rehabilitation Medicine, State University of New York at Buffalo, Buffalo, New York.

Supported, in part, by grant R01-HD34622 from the National Institutes of Health, Department of Health and Human Services. Dr. Gonzales was supported by a postdoctoral fellowship (H133P990001) from the National Institute on Disability and Rehabilitation Research, Department of Education, Advanced Rehabilitation Research Training Program.

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

All correspondence and requests for reprints should be addressed to Kenneth Ottenbacher, PhD, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-1028.

© 2001 Lippincott Williams & Wilkins, Inc.