Cary, M. and Baernholdt, M. and Anderson, R. and Merwin, E., Performance-based Outcomes of Inpatient Rehabilitation Facilities Treating Hip Fracture Patients in the United States.,
Archives of physical medicine and rehabilitation
(January 13, 2015 Epub ahead of print), ISSN 1532-821X [doi]
(last updated on 2015/05/28)
Abstract:
OBJECTIVE: To examine the influence of facility and aggregate patient characteristics of inpatient rehabilitation facilities (IRFs) on performance-based rehabilitation outcomes in a national sample of IRFs treating Medicare beneficiaries with hip fracture. METHODS: Secondary data analysis. METHODS: 983 US Medicare-certified IRFs. Data included 34,364 patient records of Medicare beneficiaries admitted in 2009 for rehabilitation after hip fracture. METHODS: Performance-based outcomes included mean motor function on discharge, mean motor change (mean motor score on discharge minus mean motor score on admission) and percentage discharged to the community. RESULTS: Higher mean motor function on discharge was explained by aggregate characteristics of hip fracture patients (lower age [<0.009], lower percentage of Blacks [<0.001] and Hispanics [<0.001], higher percentage of females [<0.001], higher motor function on admission [<0.001], longer length of stay [<0.001]) and facility characteristics (freestanding [<0.001], rural [<0.001], for-profit [0.048], and smaller IRFs [<0.014]). The findings were similar for motor change, but motor change was also associated with lower mean cognitive function on admission (0.008). Higher percentage discharged to the community was associated with aggregate patient characteristics (lower age [<0.001], lower percentage of Hispanics [0.009], higher percentage of patients living with others [<0.001], and higher motor function on admission [<0.001]). No facility characteristics were associated with percentage discharged to the community. CONCLUSIONS: Performance-based measurement offers health policymakers, administrators, clinicians, and consumers a major opportunity for securing health system improvement by benchmarking or comparing their outcomes to other similar facilities. These results might serve as the basis for benchmarking and quality-based reimbursement to IRFs for one impairment group: hip fracture.
Keywords:
Health Services Research • Hip Fractures • Medicare • Outcome Assessment (Health Care) • Rehabilitation Centers
