Article

The objective of this work was to present comprehensive descriptive
summaries of program interruptions and short-stay transfers among Medicare
fee-for-service beneficiaries receiving inpatient rehabilitation after stroke,
traumatic brain injury (TBI), and traumatic spinal cord injury (SCI). DESIGN: Retrospective cohort study of Medicare beneficiaries with any of the 3 conditions
of interest who were admitted to inpatient rehabilitation directly from an acute
hospital between July 1, 2012, and November 15, 2013. RESULTS: In the final
sample (stroke, n = 71 769; TBI, n = 7109; SCI, n = 659), program interruption
rates were 0.9% (stroke), 0.8% (TBI), and 1.4% (SCI). Short-stay transfer rates
were 22.3% (stroke), 21.8% (TBI), and 31.6% (SCI); 14.7%of short-stay transfers
and 12.3% of interruptions resulting in a return to acute care were identified as
potentially preventable among those with stroke; 10.2% of transfers and 11.7% of
interruptions among those with TBI, and 3.8% of transfers and 11.1% of interruptions among those with SCI. CONCLUSIONS: Broad health care policies aimed
at improving quality and reducing costs are currently being implemented. Reducing
program interruptions and short-stay transfers during inpatient rehabilitative
care represents a potential target for care-improvement efforts. Future research
focused on identifying modifiable risk factors for potentially undesirable
outcomes will allow for targeted preventative interventions.

Langue : ANGLAIS