Article

OBJECTIVE: To compare functional outcomes between children receiving inpatient
rehabilitation at children's hospitals and those at other facilities. DESIGN:
Retrospective cohort study. SETTING: Inpatient rehabilitation facilities.
PARTICIPANTS: Children
(N=28,793) aged 6 months to 18 years who received initial
inpatient rehabilitation. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES:
Total, cognitive, and motor developmental functional quotients (DFQs; which is
the WeeFIM score divided by age-adjusted norms and multiplied by 100) at
discharge from inpatient rehabilitation and WeeFIM efficiency (the change in
WeeFIM score from admission to discharge divided by the length of the
rehabilitation stay), adjusting for age, sex, race, insurance, region, admission
function, impairment type, discharge year, and length of stay. RESULTS: A total
of 12,732 children received rehabilitation at 25 children's hospitals and 16,061
at 36 other facilities (general hospitals or freestanding rehabilitation
hospitals). Adjusting for clustering by facility, patients at children's
hospitals had a lower cognitive DFQ at admission (difference between children's
hospitals and other facility types, -3.8; 95% confidence interval [CI], -7.7 to
-0.1), a shorter length of stay (median, 16d vs 22d; P<.001), and a higher WeeFIM
efficiency (difference, 0.63; 95% CI, 0.25-1.00) than did children at other
facility types. Rehabilitation in a children's hospital was independently
associated with a higher discharge cognitive DFQ (regression coefficient, 2.3;
95% CI, 0.3-4.2) and more efficient rehabilitation admissions (regression
coefficient, 0.3; 95% CI, 0.1-0.6). CONCLUSIONS: Children who receive inpatient
rehabilitation at children's hospitals have more efficient inpatient
rehabilitation admissions, a shorter median length of stay, and a slight
improvement in cognitive function than do children at other facility types.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS