TY - JOUR
T1 - FIM motor scores for classifying community discharge after inpatient rehabilitation for hip fracture
AU - Wang, Ching Yi
AU - Graham, James E.
AU - Karmarkar, Amol M.
AU - Reistetter, Timothy A.
AU - Protas, Elizabeth J.
AU - Ottenbacher, Kenneth J.
N1 - Funding Information:
Research support: This project was funded in part by National Institutes of Health grants R24 HD065702 to J.E.G., A.M.K., and K.J.O., K01 HD068513 to T.A.R., and CTSA 8UL1TR000071 to A.M.K., T.A.R., and K.J.O. and Agency for Health Research & Quality grant R24 HS022134 to J.E.G., T.A.R., and K.J.O.
PY - 2014/6
Y1 - 2014/6
N2 - 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.
AB - 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.
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U2 - 10.1016/j.pmrj.2013.12.008
DO - 10.1016/j.pmrj.2013.12.008
M3 - Article
C2 - 24389348
AN - SCOPUS:84902797634
SN - 1934-1482
VL - 6
SP - 493
EP - 497
JO - PM and R
JF - PM and R
IS - 6
ER -