The American Rehabilitation Association recently (1994) reported that the average hospital operating cost per inpatient medical rehabilitation day for Medicare and non-Medicare patients was $561.00. The cost per day of inpatient medical rehabilitation increased approximately 40% from 1986 to 1992. National data currently exist on length of stay (LOS) and other variables related to initial inpatient rehabilitation. No information, however, has been published examining the rate and cost of rehospitalization for patients following discharge from inpatient medical rehabilitation. The purpose of this investigation is to systematically examine a large sample of community based persons who received inpatient medical rehabilitation. Follow-up data collected by the National Followup Services will be analyzed. The National Followup Services collects follow-up information on patients who received inpatient medical rehabilitation at facilities that provide data to the Uniform Data System for Medical Rehabilitation (UDSmr). The National Followup Services data base contains approximately 35,000 records for persons living in the U.S. The data base includes demographic variables, medical history, and Functional Independence Measure ratings for each subject. National Followup Services data will be compared to records in the UDSmr data base to determine the comparability of patients in the follow-up data set. Elements of the National Followup Services data base will be examined with particular attention to the variable of rehospitalization. Rehospitalization will be investigated for various impairment groups and age categories. Discriminant function analysis will be used to examine the relationship between demographic characteristics (age, sex, etc.), medical history, and FIM ratings and incidents of rehospitalization. The results of Discriminant function analysis will be compared to predictions of rehospitalization obtained using neural network simulation software. Discriminant function analysis and neural network analysis will be used to develop prediction models to determine characteristics and patterns of variables associated with hospital readmission for different impairment groups. The development of prediction models for rehospitalization of persons receiving medical rehabilitation will improve the effective use of future resources.
| Ottenbacher, Kenneth J; Linn, Richard T; Smith, Pamela M et al. (2004) Comparison of logistic regression and neural network analysis applied to predicting living setting after hip fracture. Ann Epidemiol 14:551-9 |
| Ottenbacher, Kenneth J; Smith, Pam M; Illig, Sandra B et al. (2004) Trends in length of stay, living setting, functional outcome, and mortality following medical rehabilitation. JAMA 292:1687-95 |
| Mancuso, Melodee; Smith, Pamela; Illig, Sandra et al. (2003) Satisfaction with medical rehabilitation in patients with orthopedic impairment. Arch Phys Med Rehabil 84:1343-9 |
| Ottenbacher, Kenneth J; Smith, Pam M; Illig, Sandra B et al. (2003) Hospital readmission of persons with hip fracture following medical rehabilitation. Arch Gerontol Geriatr 36:15-22 |
| Ottenbacher, Kenneth J; Smith, Pamela M; Illig, Sandra B et al. (2003) Disparity in health services and outcomes for persons with hip fracture and lower extremity joint replacement. Med Care 41:232-41 |
| Ottenbacher, Kenneth J; Smith, Pam M; Illig, Sandra B et al. (2002) Prediction of follow-up living setting in patients with lower limb joint replacement. Am J Phys Med Rehabil 81:471-7 |
| Smith, Pam M; Ottenbacher, Kenneth J; Cranley, Mecca et al. (2002) Predicting follow-up living setting in patients with stroke. Arch Phys Med Rehabil 83:764-70 |
| Ottenbacher, K J; Smith, P M; Illig, S B et al. (2001) Characteristics of persons rehospitalized after stroke rehabilitation. Arch Phys Med Rehabil 82:1367-74 |
| Ottenbacher, K J; Smith, P M; Illig, S B et al. (2001) Comparison of logistic regression and neural networks to predict rehospitalization in patients with stroke. J Clin Epidemiol 54:1159-65 |
| Ottenbacher, K J; Gonzales, V A; Smith, P M et al. (2001) Satisfaction with medical rehabilitation in patients with cerebrovascular impairment. Am J Phys Med Rehabil 80:876-84 |
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