Article

OBJECTIVE: To determine the prevalence of diabetes in inpatient rehabilitation
facilities in Washington State from 2001 to 2007, and to determine the impact of
diabetes on length of stay (LOS) and charges per day. DESIGN: Longitudinal
retrospective cohort analysis of inpatient rehabilitation discharge data from the
Washington State Department of Health Comprehensive Hospital Abstract Reporting
System. SETTING: Inpatient rehabilitation. PARTICIPANTS: Adults (N=56,382) who
were discharged from inpatient rehabilitation in Washington State between 2001
and 2007. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Evidence of an
established diagnosis of diabetes from International Classification of Diseases,
9th Revision, Clinical Modification (ICD-9-CM) diagnosis codes; comorbid
conditions reported in ICD-9-CM codes; LOS; and charges per stay. RESULTS: For
all discharges from 2001 to 2007, diabetes prevalence was 17.8%; prevalence
within specific impairment groups was 21.3% for the stroke subgroup, 14.2% for
the orthopedic disorders subgroup, and 25% for the medically complex conditions
subgroup. For all discharges, and within each impairment subgroup, prevalence did
not change significantly from year to year. When adjusted for burden of
nondiabetes comorbidities, LOS was significantly shorter for all discharges with
diabetes younger than 65 years. The association between a diabetes codiagnosis
and LOS in specific impairment groups was complex, ranging from a significantly
shorter LOS for discharges with diabetes in the stroke subgroup to a finding of
no significant difference in LOS among discharges with or without diabetes in the
orthopedic impairments subgroup. Across all discharges, charges per day from 2003
to 2007 were significantly greater in discharges with diabetes. Within each
specific impairment subgroup, charges per day across the entire study period were
significantly greater for discharges with diabetes. CONCLUSIONS: The high
prevalence of diabetes, coupled with its impact on resource use, suggests that
substantial pressures may be placed on the inpatient rehabilitation care system
to respond to the needs of those with diabetes.

Langue : ANGLAIS