The uniform data system for medical rehabilitation

Report of patients with traumatic spinal cord injury discharged from rehabilitation programs in 2002-2010

Carl V. Granger, Amol Karmarkar, James E. Graham, Anne Deutsch, Paulette Niewczyk, Margaret A. Divita, Kenneth Ottenbacher

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objective: This study aimed to provide benchmarking information from a large national sample of patients receiving inpatient rehabilitation after a traumatic spinal cord injury. Design: This was an analysis of secondary data from 891 inpatient medical rehabilitation facilities in the United States that contributed traumatic spinal cord injury data to the Uniform Data System for Medical Rehabilitation from January 2002 to December 2010. Variables analyzed included demographic information (age, sex, marital status, race/ethnicity, prehospital living setting, discharge setting), hospitalization information (length of stay, program interruptions, payer, onset date, rehabilitation impairment group, International Classification of Diseases 9 codes for admitting diagnosis, co-morbidities), and functional status (Functional Independence Measure [FIM] instrument ratings at admission and discharge, FIM efficiency, FIM gain). Results: The final sample included 47,153 patients with traumatic spinal cord injury. Overall, the mean length of stay was 26.2 ± 23.2 days: yearly means ranged from 29.7 ± 25.4 in 2002 to 22.9 ± 18.9 in 2009. FIM total admission and discharge ratings also declined during the 8-yr study period; admission decreased from 60.5 ± 17.4 to 55.9 ± 16.3; discharge decreased from 86.1 ± 23.8 to 82.4 ± 23.4. Rehabilitation efficiency (FIM gain per day) remained relatively stable over time (1.6 ± 1.7 points per day). The percentage of all patients discharged to the community ranged from 75.8% to 71.5% per year. Wheelchair users stayed in rehabilitation longer than did persons who could walk (34.6 ± 217.4 vs. 17.4 ± 14.1 days) and also experienced less functional improvement (21.6 ± 15.8 vs. 29.6 ± 16.3 FIM points). Conclusions: National data from persons with traumatic spinal cord injury in 2002-2010 indicate that lengths of stay declined, but efficiency in functional independence was stable to slightly increased. More than 70% of patients were consistently discharged to community settings after inpatient rehabilitation.

Original languageEnglish (US)
Pages (from-to)289-299
Number of pages11
JournalAmerican Journal of Physical Medicine and Rehabilitation
Volume91
Issue number4
DOIs
StatePublished - Apr 2012

Fingerprint

Spinal Cord Injuries
Information Systems
Rehabilitation
Inpatients
Length of Stay
Benchmarking
Wheelchairs
Marital Status
International Classification of Diseases
Hospitalization
Demography
Morbidity

Keywords

  • Benchmarking
  • Quality Improvement
  • Spinal Cord Injuries

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Medicine(all)

Cite this

The uniform data system for medical rehabilitation : Report of patients with traumatic spinal cord injury discharged from rehabilitation programs in 2002-2010. / Granger, Carl V.; Karmarkar, Amol; Graham, James E.; Deutsch, Anne; Niewczyk, Paulette; Divita, Margaret A.; Ottenbacher, Kenneth.

In: American Journal of Physical Medicine and Rehabilitation, Vol. 91, No. 4, 04.2012, p. 289-299.

Research output: Contribution to journalArticle

Granger, Carl V. ; Karmarkar, Amol ; Graham, James E. ; Deutsch, Anne ; Niewczyk, Paulette ; Divita, Margaret A. ; Ottenbacher, Kenneth. / The uniform data system for medical rehabilitation : Report of patients with traumatic spinal cord injury discharged from rehabilitation programs in 2002-2010. In: American Journal of Physical Medicine and Rehabilitation. 2012 ; Vol. 91, No. 4. pp. 289-299.
@article{f4f5d7f1f46d460ca3f2ff29158590af,
title = "The uniform data system for medical rehabilitation: Report of patients with traumatic spinal cord injury discharged from rehabilitation programs in 2002-2010",
abstract = "Objective: This study aimed to provide benchmarking information from a large national sample of patients receiving inpatient rehabilitation after a traumatic spinal cord injury. Design: This was an analysis of secondary data from 891 inpatient medical rehabilitation facilities in the United States that contributed traumatic spinal cord injury data to the Uniform Data System for Medical Rehabilitation from January 2002 to December 2010. Variables analyzed included demographic information (age, sex, marital status, race/ethnicity, prehospital living setting, discharge setting), hospitalization information (length of stay, program interruptions, payer, onset date, rehabilitation impairment group, International Classification of Diseases 9 codes for admitting diagnosis, co-morbidities), and functional status (Functional Independence Measure [FIM] instrument ratings at admission and discharge, FIM efficiency, FIM gain). Results: The final sample included 47,153 patients with traumatic spinal cord injury. Overall, the mean length of stay was 26.2 ± 23.2 days: yearly means ranged from 29.7 ± 25.4 in 2002 to 22.9 ± 18.9 in 2009. FIM total admission and discharge ratings also declined during the 8-yr study period; admission decreased from 60.5 ± 17.4 to 55.9 ± 16.3; discharge decreased from 86.1 ± 23.8 to 82.4 ± 23.4. Rehabilitation efficiency (FIM gain per day) remained relatively stable over time (1.6 ± 1.7 points per day). The percentage of all patients discharged to the community ranged from 75.8{\%} to 71.5{\%} per year. Wheelchair users stayed in rehabilitation longer than did persons who could walk (34.6 ± 217.4 vs. 17.4 ± 14.1 days) and also experienced less functional improvement (21.6 ± 15.8 vs. 29.6 ± 16.3 FIM points). Conclusions: National data from persons with traumatic spinal cord injury in 2002-2010 indicate that lengths of stay declined, but efficiency in functional independence was stable to slightly increased. More than 70{\%} of patients were consistently discharged to community settings after inpatient rehabilitation.",
keywords = "Benchmarking, Quality Improvement, Spinal Cord Injuries",
author = "Granger, {Carl V.} and Amol Karmarkar and Graham, {James E.} and Anne Deutsch and Paulette Niewczyk and Divita, {Margaret A.} and Kenneth Ottenbacher",
year = "2012",
month = "4",
doi = "10.1097/PHM.0b013e31824ad2fd",
language = "English (US)",
volume = "91",
pages = "289--299",
journal = "American Journal of Physical Medicine and Rehabilitation",
issn = "0894-9115",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - The uniform data system for medical rehabilitation

T2 - Report of patients with traumatic spinal cord injury discharged from rehabilitation programs in 2002-2010

AU - Granger, Carl V.

AU - Karmarkar, Amol

AU - Graham, James E.

AU - Deutsch, Anne

AU - Niewczyk, Paulette

AU - Divita, Margaret A.

AU - Ottenbacher, Kenneth

PY - 2012/4

Y1 - 2012/4

N2 - Objective: This study aimed to provide benchmarking information from a large national sample of patients receiving inpatient rehabilitation after a traumatic spinal cord injury. Design: This was an analysis of secondary data from 891 inpatient medical rehabilitation facilities in the United States that contributed traumatic spinal cord injury data to the Uniform Data System for Medical Rehabilitation from January 2002 to December 2010. Variables analyzed included demographic information (age, sex, marital status, race/ethnicity, prehospital living setting, discharge setting), hospitalization information (length of stay, program interruptions, payer, onset date, rehabilitation impairment group, International Classification of Diseases 9 codes for admitting diagnosis, co-morbidities), and functional status (Functional Independence Measure [FIM] instrument ratings at admission and discharge, FIM efficiency, FIM gain). Results: The final sample included 47,153 patients with traumatic spinal cord injury. Overall, the mean length of stay was 26.2 ± 23.2 days: yearly means ranged from 29.7 ± 25.4 in 2002 to 22.9 ± 18.9 in 2009. FIM total admission and discharge ratings also declined during the 8-yr study period; admission decreased from 60.5 ± 17.4 to 55.9 ± 16.3; discharge decreased from 86.1 ± 23.8 to 82.4 ± 23.4. Rehabilitation efficiency (FIM gain per day) remained relatively stable over time (1.6 ± 1.7 points per day). The percentage of all patients discharged to the community ranged from 75.8% to 71.5% per year. Wheelchair users stayed in rehabilitation longer than did persons who could walk (34.6 ± 217.4 vs. 17.4 ± 14.1 days) and also experienced less functional improvement (21.6 ± 15.8 vs. 29.6 ± 16.3 FIM points). Conclusions: National data from persons with traumatic spinal cord injury in 2002-2010 indicate that lengths of stay declined, but efficiency in functional independence was stable to slightly increased. More than 70% of patients were consistently discharged to community settings after inpatient rehabilitation.

AB - Objective: This study aimed to provide benchmarking information from a large national sample of patients receiving inpatient rehabilitation after a traumatic spinal cord injury. Design: This was an analysis of secondary data from 891 inpatient medical rehabilitation facilities in the United States that contributed traumatic spinal cord injury data to the Uniform Data System for Medical Rehabilitation from January 2002 to December 2010. Variables analyzed included demographic information (age, sex, marital status, race/ethnicity, prehospital living setting, discharge setting), hospitalization information (length of stay, program interruptions, payer, onset date, rehabilitation impairment group, International Classification of Diseases 9 codes for admitting diagnosis, co-morbidities), and functional status (Functional Independence Measure [FIM] instrument ratings at admission and discharge, FIM efficiency, FIM gain). Results: The final sample included 47,153 patients with traumatic spinal cord injury. Overall, the mean length of stay was 26.2 ± 23.2 days: yearly means ranged from 29.7 ± 25.4 in 2002 to 22.9 ± 18.9 in 2009. FIM total admission and discharge ratings also declined during the 8-yr study period; admission decreased from 60.5 ± 17.4 to 55.9 ± 16.3; discharge decreased from 86.1 ± 23.8 to 82.4 ± 23.4. Rehabilitation efficiency (FIM gain per day) remained relatively stable over time (1.6 ± 1.7 points per day). The percentage of all patients discharged to the community ranged from 75.8% to 71.5% per year. Wheelchair users stayed in rehabilitation longer than did persons who could walk (34.6 ± 217.4 vs. 17.4 ± 14.1 days) and also experienced less functional improvement (21.6 ± 15.8 vs. 29.6 ± 16.3 FIM points). Conclusions: National data from persons with traumatic spinal cord injury in 2002-2010 indicate that lengths of stay declined, but efficiency in functional independence was stable to slightly increased. More than 70% of patients were consistently discharged to community settings after inpatient rehabilitation.

KW - Benchmarking

KW - Quality Improvement

KW - Spinal Cord Injuries

UR - http://www.scopus.com/inward/record.url?scp=84859098121&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84859098121&partnerID=8YFLogxK

U2 - 10.1097/PHM.0b013e31824ad2fd

DO - 10.1097/PHM.0b013e31824ad2fd

M3 - Article

VL - 91

SP - 289

EP - 299

JO - American Journal of Physical Medicine and Rehabilitation

JF - American Journal of Physical Medicine and Rehabilitation

SN - 0894-9115

IS - 4

ER -