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The Uniform Data System for Medical Rehabilitation: Report of Patients with Traumatic Brain Injury Discharged from Rehabilitation Programs in 2000–2007

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

American Journal of Physical Medicine & Rehabilitation: April 2010 - Volume 89 - Issue 4 - p 265-278
doi: 10.1097/PHM.0b013e3181d3eb20
Original Research Article: Outcomes

Granger CV, Markello SJ, Graham JE, Deutsch A, Reistetter TA, Ottenbacher KJ: The Uniform Data System for Medical Rehabilitation: Report of patients with traumatic brain injury discharged from rehabilitation programs in 2000–2007.

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

Design: Secondary data analysis from 893 medical rehabilitation facilities located in the United States that contributed information to the Uniform Data System for Medical Rehabilitation from January 2000 through December 2007. Variables analyzed included demographic information (age, sex, marital status, race or ethnicity, prehospital living setting, and discharge setting), hospitalization information (length of stay, program interruptions, payer, onset date, rehabilitation impairment group, Internation Classification of Diseases–9th revision codes for admitting diagnosis, and co-morbidities), and functional status information (FIM instrument [FIM] ratings at admission and discharge, FIM efficiency, FIM gain).

Results: Descriptive statistics from 101,188 patients showed length of stay decreasing from a mean of 22.7 (±20.5) days to 16.6 (±14.8) days during the 8-yr study period. FIM total admission and discharge ratings also decreased. Mean admission ratings decreased from 58.6 (±24.7) to 54.8 (±21.2). Mean discharge ratings decreased from 92.4 (±24.2) to 85.0 (±24.0). Accordingly, mean functional independence measure change decreased from 33.8 (±20.5) to 30.2 (±18.4). The percentage of patients discharged to the community settings ranged from 81.3% in 2000 to 74.1% in 2007. All results are likely influenced by various policy changes affecting classification or documentation processes or both.

Conclusions: National rehabilitation data from persons with traumatic brain injury in 2000–2007 indicate that patients are spending less time in an inpatient care setting than in the previous years and are experiencing improvements in functional independence during their stay. In addition, a majority of patients are discharged to community settings after inpatient rehabilitation.

From the Uniform Data System for Medical Rehabilitation (CVG, SJM), Division of UB Foundation Activities, Inc., Buffalo, New York; Division of Rehabilitation Sciences (JEG, KJO), University of Texas Medical Branch, Galveston, Texas; Rehabilitation Institute of Chicago and Department of Physical Medicine and Rehabilitation (AD), Feinberg School of Medicine and Institute for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; and Department of Occupational Therapy (TAR), East Carolina University, Greenville, North Carolina.

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

This work was funded in part by grants H133G080163 (to KJO) and H133F090030 (to JEG) from the National Institute on Disability and Rehabilitation Research, U.S. Department of Education. 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.

© 2010 Lippincott Williams & Wilkins, Inc.