Changes in the status of hospitalized stroke patients since inception of the prospective payment system in 1983
| Autor: | Susan M. Schmidt, Steven J. Scheer, Lin Guo |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
Rehabilitation Stroke patient business.industry Public health Incidence (epidemiology) medicine.medical_treatment Psychological intervention Physical Therapy Sports Therapy and Rehabilitation medicine.disease Acute care medicine Physical therapy Prospective payment system business Stroke |
| Zdroj: | Archives of Physical Medicine and Rehabilitation. 83:894-898 |
| ISSN: | 0003-9993 |
| DOI: | 10.1053/apmr.2002.33219 |
| Popis: | Schmidt SM, Guo L, Scheer SJ. Changes in the status of hospitalized stroke patients since inception of the prospective payment system in 1983. Arch Phys Med Rehabil 2002;83:894-8. Objective: To describe epidemiologically the changes in acute-care delivery services for stroke victims since the inception of the 1983 prospective payment system (PPS). Design: A cross-sectional comparison of 2 acute-care hospitalized samples of stroke patients before and after implementation of PPS. Setting: Fifteen acute-care hospitals. Participants: A total of 1992 stroke patients discharged from 15 acute care hospitals in 1995–1996 were compared with 1665 patients studied in the same geographic area in 1981–1982. Interventions: Not applicable. Main Outcome Measures: Incidence rates, length of stay (LOS), discharge destinations, in-hospital transfers, and mortality. Results: Incidence rates between the 2 time periods remained similar (1.13–1.14/1000). Major changes between 1981–1982 and 1995–1996 included reengineering of hospitals to establish subacute units with an increased use of rehabilitation units, a 63% decrease in acute hospital LOS, a 44% increase in discharges to long-term care facilities, a 39% decrease in mortality, and a 5% decrease in discharge to home. Age (avg, 71y), gender, and living arrangements confounded discharge destinations. Significantly more men in 1995–1996 had strokes at younger ages, but overall 53% were women. Conclusions: Institution of the PPS has dramatically influenced hospital LOS, location of treatment, and discharge destinations with no improvement in home discharges. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation |
| Databáze: | OpenAIRE |
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