FIM motor scores for classifying community discharge after inpatient rehabilitation for hip fracture

Ching Yi Wang, James E. Graham, Amol Karmarkar, Timothy Reistetter, Elizabeth J. Protas, Kenneth Ottenbacher

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Objective: To assess the utility of functional status in classifying patients by discharge setting after inpatient rehabilitation for hip fracture. Design: Retrospective cohort study. Setting: A total of 1257 inpatient rehabilitation facilities in the United States. Patients: Medicare beneficiaries (N= 117,168) receiving inpatient rehabilitation for hip fracture from 2007 to 2009. Methods: Receiver operating characteristic curve analyses to assess the overall discriminatory ability of functional status scores (Functional Independence Measure [FIM] total, FIM cognition, and FIM motor) and to identify the functioning threshold that best differentiates patients by discharge setting. Main Outcome Measurements: Discharge setting (community versus institutional). Results: Approximately 68% of patients were discharged to the community after inpatient rehabilitation for hip fracture. Receiver operating characteristic curve analyses indicate that discharge FIM motor ratings (area under the curve: 0.84) alone are as effective as a multivariable model (area under the curve: 0.85), including sociodemographic and clinical factors, in discriminating patients discharged to the community from those discharged to an institution. A discharge FIM motor rating of 58 yielded the best balance in sensitivity and specificity for classifying patients by discharge setting. Conclusions: Discharge FIM motor ratings demonstrated good discriminatory ability for classifying discharge setting. An FIM motor rating of 58 may serve as a clinical tool to guide treatment plans and/or as additional information in complex discharge planning decisions for patients with hip fracture.

Original languageEnglish (US)
Pages (from-to)493-497
Number of pages5
JournalPM and R
Volume6
Issue number6
DOIs
StatePublished - 2014

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Patient Discharge
Hip Fractures
Inpatients
Rehabilitation
Aptitude
ROC Curve
Area Under Curve
Motor Cortex
Medicare
Cognition
Cohort Studies
Retrospective Studies
Sensitivity and Specificity
Therapeutics

ASJC Scopus subject areas

  • Rehabilitation
  • Neurology
  • Clinical Neurology
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

FIM motor scores for classifying community discharge after inpatient rehabilitation for hip fracture. / Wang, Ching Yi; Graham, James E.; Karmarkar, Amol; Reistetter, Timothy; Protas, Elizabeth J.; Ottenbacher, Kenneth.

In: PM and R, Vol. 6, No. 6, 2014, p. 493-497.

Research output: Contribution to journalArticle

Wang, Ching Yi ; Graham, James E. ; Karmarkar, Amol ; Reistetter, Timothy ; Protas, Elizabeth J. ; Ottenbacher, Kenneth. / FIM motor scores for classifying community discharge after inpatient rehabilitation for hip fracture. In: PM and R. 2014 ; Vol. 6, No. 6. pp. 493-497.
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