Inpatient Rehabilitation After Stroke

Abstract

Patients have longer lengths of hospital stay (LOS) in VA medical centers than in the general health care system. The objective of this study was to determine whether resource use and outcome differences between VA and non-VA inpatient rehabilitation facilities remain after controlling for patient and medical care delivery differences. This analysis involved 60 VA inpatient rehabilitation units and 467 non-VA rehabilitation hospitals and units. Multivariate adjusted resource use and patient outcome differences were compared across setting within patients grouped by severity of disability at admission through assignment to the Function Related Group (FRG) patient classification system. The study included 55,438 stroke patients. Study measures were LOS, functional status at discharge, and community discharge. The VA serves a higher proportion of patients who are single, separated, or divorced; are unemployed or retired as a result of disability, and are not white (P Conclusions. While certain variables accounted for some of the observed differences in resource use and outcomes, differences remained after adjustment. Fewer incentives for cost containment and less support in patients’ home environments may be among the most important unmeasured determinants of VA differences.