The Uniform Data System for Medical Rehabilitation: report of patients with debility discharged from inpatient rehabilitation programs in 2000-2010.

Galloway RV, Granger CV, Karmarkar AM, Graham JE, Deutsch A, Niewczyk P, DiVita MA, Ottenbacher KJ: The Uniform Data System for Medical Rehabilitation: Report of patients with debility discharged from inpatient rehabilitation programs in 2000-2010. Am J Phys Med Rehabil 2013;92:14-27. Objective: Benchmark data are provided for a national sample of patients who received inpatient rehabilitation for debility. Design: Patients with debility from 830 inpatient rehabilitation facilities in the United States contributing to the Uniform Data System for Medical Rehabilitation from 2000 to 2010 were examined. Demographic information (age, marital status, sex, race/ethnicity, prehospital living setting, and discharge setting), hospital information (length of stay, program interruptions, payer, and codes for admitting diagnosis), and functional status (Functional Independence Measure [FIM] instrument ratings at admission and discharge, FIM change, and FIM efficiency) were analyzed. Results: Data from 2000 to 2010 (N = 260,373) revealed a decrease in mean (SD) FIM total admission ratings from 73.9 (16.2) to 62.5 (15.8). The FIM total discharge ratings decreased from 95.0 (19.7) to 88.2 (19.8). Mean (SD) length of stay decreased from 14.3 (9.1) to 12.1 (6.2) days. The FIM efficiency (change/day) increased from 1.9 (1.7) to 2.4 (1.9). Discharge to community decreased from 80% to 75%. Acute care discharges accounted for 12% of the cases. Policy changes affecting classification, reimbursement, and/or documentation processes may have influenced the results. Conclusions: National data indicate that the number of debility cases is increasing with diverse composition of etiologic diagnoses. A high proportion of these patients is discharged to acute care compared with other impairment groups.