Article

OBJECTIVE: To evaluate the ability of patient functional status to differentiate
between community and institutional discharges after rehabilitation for stroke.
DESIGN: Retrospective cross-sectional design. SETTING: Inpatient rehabilitation
facilities contributing to the Uniform Data System for Medical Rehabilitation.
PARTICIPANTS: Patients (N=157,066) receiving inpatient rehabilitation for stroke
from 2006 and 2007. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE:
Discharge FIM rating and discharge setting (community vs institutional). RESULTS:
Approximately 71% of the sample was discharged to the community. Receiver
operating characteristic curve analyses revealed that FIM total performed as well
as or better than FIM motor and FIM cognition subscales in differentiating
discharge settings. Area under the curve for FIM total was .85, indicating very
good ability to identify persons discharged to the community. A FIM total rating
of 78 was identified as the optimal cut point for distinguishing between positive
(community) and negative (institution) tests. This cut point yielded balanced
sensitivity and specificity (both=.77). CONCLUSIONS: Discharge planning is
complex, involving many factors. Identifying a functional threshold for
classifying discharge settings can provide important information to assist in
this process. Additional research is needed to determine if the risks and
benefits of classification errors justify shifting the cut point to weight either
sensitivity or specificity of FIM ratings.
CI - Copyright 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS