Article

OBJECTIVE: To characterize rehabilitation services for patients with knee and hip
replacement in 3 types of postacute facilities in the U.S. DESIGN: Multi-site
prospective observational cohort study. SETTING: Eight freestanding skilled
nursing facilities (SNFs), 1 hospital-based SNF, and 11 inpatient rehabilitation
facilities (IRFs). PARTICIPANTS: Patients (N=2158) with knee or hip replacement.
INTERVENTIONS: No new interventions.
MAIN OUTCOME MEASURES: Length of stay (LOS),
amount and intensity of physical therapy (PT) and occupational therapy (OT),
types of therapy activities. RESULTS: Average LOS was about 15 days for
freestanding SNF patients, and 9 to 10 days for hospital-based SNF and IRF
patients. Freestanding SNFs and IRFs provide about the same number of hours of PT
and OT; the hospital-based SNF provided 27% fewer hours. Freestanding SNFs and
the hospital-based SNF provided fewer hours a day than did IRFs. Joint
replacement patients across all 3 types of facilities spent, on average, 70% to
75% of their PT time in just 2 activities--exercise and gait and spent 56% to 66%
of their OT time in 3 activities--exercise, functional mobility, and dressing
lower body. CONCLUSIONS: Both freestanding SNFs and IRFs provided similar amounts
of PT with a similar emphasis on exercise and gait activities. IRFs, however,
provided more OT than freestanding SNFs. IRFs had shorter LOSs and more intensive
therapy services than freestanding SNFs. Study freestanding SNFs exhibited
greater variation in LOS and intensity of therapy than IRFs.

Langue : ANGLAIS