Regional variation in stroke rehabilitation outcomes

Timothy A. Reistetter, Amol M. Karmarkar, James E. Graham, Karl Eschbach, Yong Fang Kuo, Carl V. Granger, Jean Freeman, Kenneth J. Ottenbacher

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Objective: To examine and describe regional variation in outcomes for persons with stroke receiving inpatient medical rehabilitation. Design Retrospective cohort design. Setting: Inpatient rehabilitation units and facilities contributing to the Uniform Data System for Medical Rehabilitation from the United States. Participants: Patients (N=143,036) with stroke discharged from inpatient rehabilitation during 2006 and 2007. Interventions: Not applicable. Main Outcome Measures: Community discharge, length of stay (LOS), and discharge functional status ratings (motor, cognitive) across 10 geographic service regions defined by the Centers for Medicare and Medicaid Services (CMS). Results: Approximately 71% of the sample was discharged to the community. After adjusting for covariates, the percentage discharged to the community varied from 79.1% in the Southwest (CMS region 9) to 59.4% in the Northeast (CMS region 2). Adjusted LOS varied by 2.1 days, with CMS region 1 having the longest LOS at 18.3 days and CMS regions 5 and 9 having the shortest at 16.2 days. Conclusions: Rehabilitation outcomes for persons with stroke varied across CMS regions. Substantial variation in discharge destination and LOS remained after adjusting for demographic and clinical characteristics.

Original languageEnglish (US)
Pages (from-to)29-38
Number of pages10
JournalArchives of Physical Medicine and Rehabilitation
Volume95
Issue number1
DOIs
StatePublished - Jan 1 2014

Keywords

  • Health services
  • Quality of health care
  • Rehabilitation

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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    Reistetter, T. A., Karmarkar, A. M., Graham, J. E., Eschbach, K., Kuo, Y. F., Granger, C. V., Freeman, J., & Ottenbacher, K. J. (2014). Regional variation in stroke rehabilitation outcomes. Archives of Physical Medicine and Rehabilitation, 95(1), 29-38. https://doi.org/10.1016/j.apmr.2013.07.018