Measuring Functional Outcomes Across Postacute Care: Current Challenges and Future Directions

Abstract
This article reviews the challenges of developing outcome systems that are designed to assess function across postacute care settings and describes state-of-the-art research that is helping produce the next generation of functional instruments. There is growing recognition of the importance of measuring function across postacute settings; however, current limitations of existing instruments include (1) the lack of a clear theoretical framework, (2) a narrow scope of content, (3) the fragmentation of instruments across settings, and (4) a lack of feasibility. The authors highlight the key methods, such as item response theory, and introduce some preliminary findings in computerized adaptive testing applications that will guide and stimulate future research in this area.