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OBJECTIVE The aim of the study was to investigate sex differences and the impact of social living situation on individual functional independence measure outcomes after stroke rehabilitation. DESIGN A retrospective observational study using Medicare fee-for-service beneficiaries (N = 125,548) who were discharged from inpatient rehabilitation facilities in 2013 and 2014 after a stroke. Discharge individual functional independence measure score, dichotomized as ≥5 and

This article complements a series of six impairment-specific reports of multi-year data from the Uniform Data System for Medical Rehabilitation database (UDSMR® database) providing national benchmarking information for follow-up information on key rehabilitation outcomes. The current report includes follow-up data on a subset of patients with stroke, traumatic brain injury, lower extremity fracture, lower extremity joint replacement, traumatic spinal cord injury, or debility who received inpatient rehabilitation services from 2002 through 2010 in facilities that subscribed to the UDSMR. Recent reports published in this journal contain the admission and discharge benchmark information for patients in these rehabilitation impairment categories.1–6 An earlier report containing follow-up information from 1994–1996 was also published in this journal.7 Following a debilitating illness or injury, patients and family members universally desire recovery of functional independence to enable a return to community living. Traditionally, inpatient providers have had no established need and few if any resources to document patient outcomes and experiences following discharge. The Affordable Care Act8 contains several provisions (e.g. readmission reduction, bundled payments, and care coordination) that expand provider accountability beyond the immediate stay. In other words, the financial incentives (penalties) included in these provisions have heightened the interest of upstream providers in the downstream care and longer-term outcomes their patients experience. Implicit in this expanded episode-of-care framework are the needs and impacts of family caregivers and the understanding that longer-term recovery of health status and independence are largely a function of a person’s combined formal and informal care networks.9 Our goal for this report was to display yearly aggregated summaries of select rehabilitation outcomes in a natural, meaningful sequence (admission, discharge, follow-up) for patients within the six largest impairment groups receiving inpatient medical rehabilitation services. We believe this information can serve as a valuable resource for all stakeholders working to improve the long-term outcomes, care transitions, and/or care coordination for persons requiring intensive post-acute rehabilitation services.

OBJECTIVE The aim of this study was to provide benchmarking information for a large national sample of patients receiving inpatient rehabilitation because of a hip fracture. DESIGN A secondary data analysis of records from 893 medical rehabilitation facilities located in the United States that contributed information to the Uniform Data System for Medical Rehabilitation from January 2000 through December 2007 was performed. Variables analyzed included demographic information (age, sex, marital status, race/ethnicity, prehospital living setting, and discharge setting), hospitalization information (length of stay, program interruptions, payer, onset date, rehabilitation impairment group, International Classification of Diseases, Ninth Revision, codes for admitting diagnosis, comorbidities), and Functional Status Information (FIM instrument ratings at admission and discharge, FIM efficiency, and FIM gain). RESULTS Descriptive statistics from 303,594 patients showed length of stay decreasing from a mean (SD) of 14.5 (7.9) days to 13.3 (5.5) days over the 8-yr study period. FIM total admission and discharge ratings also decreased. Mean admission ratings decreased from 72.5 (14.5) to 59.9 (15.7). Mean discharge ratings decreased from 95.8 (18.1) to 86.0 (19.8). FIM change per day remained relatively stable; mean for the entire sample was 2.1 (1.6). The percentage of persons discharged to the community also decreased across the study period, ranging from 77.8% in 2000 to 70.0% in 2007. All results are likely influenced by various policy changes affecting classification and/or documentation processes. CONCLUSIONS National rehabilitation data from persons with hip fracture in 2000-2007 indicate that patients are spending less time in inpatient rehabilitation care than in previous years and are experiencing improvements in functional independence during their stay. In addition, most patients are discharged to the community after inpatient rehabilitation.

To provide benchmarking information for a large national sample of patients receiving inpatient rehabilitation after a stroke.Analysis of secondary data from 893 medical rehabilitation facilities located in the United States and contributing information to the Uniform Data System for Medical Rehabilitation from 2000 to 2007.Variables analyzed included demographic information (age, sex, marital status, race/ethnicity, prehospital living setting, and discharge setting), hospitalization information (length of stay, program interruptions, payer, event onset date, rehabilitation impairment group, International Classification of Diseases-9 codes for the admitting diagnosis, and comorbidities), and functional status information (FIM(R) instrument ["FIM"] ratings at admission and discharge, FIM efficiency, and FIM gain). Descriptive statistics revealed that the length of stay decreased from a mean of 19.6 (+/-12.8) days to 16.5 (+/-9.8) days during the 8-yr study period. FIM instrument admission and discharge ratings also decreased. Mean admission ratings decreased from 62.5 (+/-20.1) to 55.1 (+/-19.3), and mean discharge ratings decreased from 86.4 (+/-23.6) to 79.8 (+/-24.0). FIM change remained relatively stable; the mean for the entire sample was 23.9 (+/-14.8). The percent of persons discharged to the community ranged from 75.8% in 2000 to 69.3% in 2007. All results are likely affected by changes in the definition for program interruption and procedures for FIM data collection.Uniform Data System for Medical Rehabilitation data from persons with stroke receiving rehabilitation from 2000 to 2007 indicate patients are showing improvement in functional independence during their rehabilitation stay, and a large percentage are discharged to community settings.