Regional variation in stroke rehabilitation outcomes
OBJECTIVE: To examine and describe regional variation in outcomes for persons with stroke receiving inpatient medical rehabilitation.
DESIGN: Retrospective cohort design.
SETTING: Inpatient rehabilitation units and facilities contributing to the Uniform Data System for Medical Rehabilitation from the United States.
PARTICIPANTS: Patients (N=143,036) with stroke discharged from inpatient rehabilitation during 2006 and 2007.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Community discharge, length of stay (LOS), and discharge functional status ratings (motor, cognitive) across 10 geographic service regions defined by the Centers for Medicare and Medicaid Services (CMS).
RESULTS: Approximately 71% of the sample was discharged to the community. After adjusting for covariates, the percentage discharged to the community varied from 79.1% in the Southwest (CMS region 9) to 59.4% in the Northeast (CMS region 2). Adjusted LOS varied by 2.1 days, with CMS region 1 having the longest LOS at 18.3 days and CMS regions 5 and 9 having the shortest at 16.2 days.
CONCLUSIONS: Rehabilitation outcomes for persons with stroke varied across CMS regions. Substantial variation in discharge destination and LOS remained after adjusting for demographic and clinical characteristics.
Reistetter, T. A., Karmarkar, A. M., Graham, J. E., Eschbach, K., Kuo, Y-F., Granger, C. V., ... Ottenbacher, K. J. (2014). Regional variation in stroke rehabilitation outcomes. Archives of Physical Medicine and Rehabilitation, 95(1), 29-38. DOI: 10.1016/j.apmr.2013.07.018