Outcome After Rehabilitation for Total Joint Replacement at IRF and SNF
- 1 January 2006
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in American Journal of Physical Medicine & Rehabilitation
- Vol. 85 (1), 1-5
- https://doi.org/10.1097/01.phm.0000197538.33707.d9
Abstract
The objective of this study was to determine whether outcomes differed between patients with single knee or hip joint replacement surgery undergoing rehabilitation in an inpatient rehabilitation facility (IRF) vs. skilled nursing facilities (SNFs). A retrospective chart review was performed on 87 pairs of patients treated in either an IRF or a SNF matched for age, gender, type of surgery, and Functional Independent Measure (FIM) motor score at admission. All patients discharged from the IRF for rehabilitation following single hip or knee replacement surgery in 2004 were eligible for comparison with index cases discharged from SNFs with the same diagnosis in 2004. At discharge, FIM motor scores, device used for ambulation, ambulation distance, disposition, and length of stay (LOS) were recorded. The mean LOS of IRF-treated patients was 10.3 +/- 3.3 days, compared with 20.0 +/- 10.8 days for SNF-treated patients (P < 0.005). A significantly higher percentage of IRF-treated patients were discharged directly home (IRF: 89.5%; SNF: 79.1%; P < 0.029). The mean discharge locomotion FIM score for IRF-treated patients was 5.71 +/- 0.91 compared with 4.90 +/- 1.92 for the SNF-treated patients (P < 0.004). At discharge, the mean ambulation distance of patients treated at the IRF was of 380 +/- 168 feet compared with 289 +/- 212 feet for patients treated at SNFs (P < 0.005). Significantly more of the SNF-treated patients required a walker (80.2%) for ambulation at discharge compared with patients treated at the IRF (38.3%, P < 0.001). Of the patients who were discharged home, 75% of the SNF-treated patients required homecare services compared with 41.2% of the IRF-treated patients (P < 0.001). When patients were matched for age, gender, operative diagnosis, and admission ambulation FIM, those who received rehabilitation in the IRF had, on average, a shorter length of stay and superior functional outcomes than those treated in SNFs.Keywords
This publication has 23 references indexed in Scilit:
- The relation between therapy intensity and outcomes of rehabilitation in skilled nursing facilitiesArchives of Physical Medicine and Rehabilitation, 2005
- Effect of rehabilitation site on functional recovery after hip fractureArchives of Physical Medicine and Rehabilitation, 2005
- Determinants of discharge destination following elective total hip replacementArthritis Care & Research, 2004
- UNIFORM DATA SYSTEM FOR MEDICAL REHABILITATIONAmerican Journal of Physical Medicine & Rehabilitation, 1999
- Outcome of Subacute Stroke RehabilitationStroke, 1998
- PREDICTING DISCHARGE OUTCOME AFTER ELECTIVE HIP AND KNEE ARTHROPLASTYAmerican Journal of Physical Medicine & Rehabilitation, 1995
- Acute and subacute rehabilitation for stroke: A comparisonArchives of Physical Medicine and Rehabilitation, 1995
- Refining a Case-Mix Measure for Nursing Homes: Resource Utilization Groups (RUG-III)Medical Care, 1994
- Benefit of a stroke unit: a randomized controlled trial.Stroke, 1991
- Medicare Prospective Payment and Posthospital Transfers to Subacute CareMedical Care, 1988