Article

This study aimed to provide benchmarking information from a large
national sample of patients receiving inpatient rehabilitation after a traumatic
spinal cord injury. This was an analysis of secondary data from 891
inpatient medical rehabilitation facilities in the United States that contributed
traumatic spinal cord injury data to the Uniform Data System for Medical
Rehabilitation from January 2002 to December 2010. Variables analyzed included
demographic information (age, sex, marital status, race/ethnicity, prehospital
living setting, discharge setting), hospitalization information (length of stay,
program interruptions, payer, onset date, rehabilitation impairment group,
International Classification of Diseases 9 codes for admitting diagnosis,
co-morbidities), and functional status (Functional Independence Measure [FIM]
instrument ratings at admission and discharge, FIM efficiency, FIM gain).
RESULTS: The final sample included 47,153 patients with traumatic spinal cord
injury. Overall, the mean length of stay was 26.2 +/- 23.2 days: yearly means
ranged from 29.7 +/- 25.4 in 2002 to 22.9 +/- 18.9 in 2009. FIM total admission
and discharge ratings also declined during the 8-yr study period; admission
decreased from 60.5 +/- 17.4 to 55.9 +/- 16.3; discharge decreased from 86.1 +/-
23.8 to 82.4 +/- 23.4. Rehabilitation efficiency (FIM gain per day) remained
relatively stable over time (1.6 +/- 1.7 points per day). The percentage of all
patients discharged to the community ranged from 75.8% to 71.5% per year.
Wheelchair users stayed in rehabilitation longer than did persons who could walk
(34.6 +/- 217.4 vs. 17.4 +/- 14.1 days) and also experienced less functional
improvement (21.6 +/- 15.8 vs. 29.6 +/- 16.3 FIM points). CONCLUSIONS: National
data from persons with traumatic spinal cord injury in 2002-2010 indicate that
lengths of stay declined, but efficiency in functional independence was stable to
slightly increased. More than 70% of patients were consistently discharged to
community settings after inpatient rehabilitation.

Langue : ANGLAIS