For-Profit and Not-for-Profit Inpatient Rehabilitation in Traumatic Brain Injury: Analysis of Demographics and Outcomes
| Autor: | Adam G. Lamm, Jeffrey C. Schneider, Chloe Slocum, Julie K. Silver, Richard Goldstein, Ross Zafonte, David C. Grabowski |
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| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Rehabilitation Demographics Traumatic brain injury business.industry medicine.medical_treatment Physical Therapy Sports Therapy and Rehabilitation medicine.disease Not for profit Intervention (counseling) Emergency medicine medicine For profit Prospective payment system business health care economics and organizations Inpatient rehabilitation |
| Zdroj: | Archives of Physical Medicine and Rehabilitation. 103:851-857 |
| ISSN: | 0003-9993 |
| DOI: | 10.1016/j.apmr.2021.11.003 |
| Popis: | Objective To describe differences in traumatic brain injury patient characteristics and outcomes by inpatient rehabilitation facility profit status. Design Retrospective database review utilizing the Uniform Data System for Medical Rehabilitation® (UDSMR). Setting Inpatient rehabilitation facilities. Participants Individual discharges (n = 53,630) from 877 distinct rehabilitation facilities for calendar years 2016 through 2018. Intervention NA Main Outcome Measures Patient demographic data (age, race, primary payer source), admission and discharge Functional Independence Measure® (FIM®), FIM® gain, length of stay efficiency, acute hospital readmission from for-profit and not-for-profit IRFs within 30 days, and community discharges by facility profit status. Results Patients at for-profit facilities were significantly older (69.69 vs. 64.12 years), with lower admission FIM® scores (52 vs. 57), shorter lengths of stay (13 vs. 15 days), and higher discharge FIM® scores (88 vs. 86); for-profit facilities had higher rates of community discharges (76.8% vs. 74.6%), but also had higher rates of readmission (10.3% vs. 9.9%). Conclusions The finding that for-profit facilities admit older patients who are reportedly less functional on admission and more functional on discharge, with higher rates of community discharge but higher readmission rates than not-for-profit facilities is an unexpected and potentially anomalous finding. In general, older, less functional patients who stay for shorter periods of time would not necessarily be expected to make greater functional gains. These differences should be further studied, to determine if differences in patient selection, coding/billing, or other unreported factors underlie these differences. |
| Databáze: | OpenAIRE |
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