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 language | English (US) |
|---|---|
| Pages (from-to) | 493-497 |
| Number of pages | 5 |
| Journal | PM and R |
| Volume | 6 |
| Issue number | 6 |
| DOIs | |
| State | Published - 2014 |
Fingerprint
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 journal › Article
}
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
AU - Reistetter, Timothy
AU - Protas, Elizabeth J.
AU - Ottenbacher, Kenneth
PY - 2014
Y1 - 2014
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.
UR - http://www.scopus.com/inward/record.url?scp=84902797634&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84902797634&partnerID=8YFLogxK
U2 - 10.1016/j.pmrj.2013.12.008
DO - 10.1016/j.pmrj.2013.12.008
M3 - Article
C2 - 24389348
AN - SCOPUS:84902797634
VL - 6
SP - 493
EP - 497
JO - PM and R
JF - PM and R
SN - 1934-1482
IS - 6
ER -