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

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

Research output: Contribution to journalArticle

14 Scopus citations

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 - Jun 2014

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ASJC Scopus subject areas

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

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