OBJECTIVE: To determine the functional outcomes and discharge setting of older patients receiving inpatient rehabilitation for debility (ICD-9-CM, 799.3). DESIGN: Retrospective cohort study of 63,171 individuals >or= 65 yrs old with a primary (23%) or comorbid (77%) debility diagnosis from the Uniform Data System for Medical Rehabilitation (UDSMR) database for 2002-2003. RESULTS: Patients with a primary diagnosis of debility (PDD) had a lower mean rehabilitation efficiency score (functional change per day) as compared with the rest of the subjects (1.7 vs. 1.9, P<0.001), including those with a Centers for Medicare & Medicaid Services (CMS) 75% rule primary diagnosis (1.8, P<0.001). The PDD group was less likely to be discharged home (68% vs. 73%, P<0.001) and more likely to be discharged to a hospital (13% vs. 11%, P<0.001). CONCLUSIONS: From a clinical perspective, the functional recovery of older patients with debility is essentially the same, regardless of whether this is a primary or comorbid diagnosis. Their functional improvement is also comparable with that reported for other CMS 75% rule diagnoses, although the debility patients are less likely to be discharged home. More than 10% of these patients were discharged to acute hospital settings. Further research is warranted to identify the most appropriate rehabilitation setting for patients with debility.
OBJECTIVE: To determine the functional outcomes and discharge setting of older patients receiving inpatient rehabilitation for debility (ICD-9-CM, 799.3). DESIGN: Retrospective cohort study of 63,171 individuals >or= 65 yrs old with a primary (23%) or comorbid (77%) debility diagnosis from the Uniform Data System for Medical Rehabilitation (UDSMR) database for 2002-2003. RESULTS:Patients with a primary diagnosis of debility (PDD) had a lower mean rehabilitation efficiency score (functional change per day) as compared with the rest of the subjects (1.7 vs. 1.9, P<0.001), including those with a Centers for Medicare & Medicaid Services (CMS) 75% rule primary diagnosis (1.8, P<0.001). The PDD group was less likely to be discharged home (68% vs. 73%, P<0.001) and more likely to be discharged to a hospital (13% vs. 11%, P<0.001). CONCLUSIONS: From a clinical perspective, the functional recovery of older patients with debility is essentially the same, regardless of whether this is a primary or comorbid diagnosis. Their functional improvement is also comparable with that reported for other CMS 75% rule diagnoses, although the debility patients are less likely to be discharged home. More than 10% of these patients were discharged to acute hospital settings. Further research is warranted to identify the most appropriate rehabilitation setting for patients with debility.
Authors: Rebecca V Galloway; Amol M Karmarkar; James E Graham; Alai Tan; Mukaila Raji; Carl V Granger; Kenneth J Ottenbacher Journal: Phys Ther Date: 2015-12-04
Authors: Jason R Falvey; Robert E Burke; Daniel Malone; Kyle J Ridgeway; Beth M McManus; Jennifer E Stevens-Lapsley Journal: Phys Ther Date: 2016-03-03
Authors: Daniel E Forman; Ross Arena; Rebecca Boxer; Mary A Dolansky; Janice J Eng; Jerome L Fleg; Mark Haykowsky; Arshad Jahangir; Leonard A Kaminsky; Dalane W Kitzman; Eldrin F Lewis; Jonathan Myers; Gordon R Reeves; Win-Kuang Shen Journal: Circulation Date: 2017-03-23 Impact factor: 29.690
Authors: Allison M Gustavson; Rebecca S Boxer; Amy Nordon-Craft; Robin L Marcus; Andrea Daddato; Jennifer E Stevens-Lapsley Journal: Phys Ther J Policy Adm Leadersh Date: 2018-08
Authors: Rebecca V Galloway; Carl V Granger; Amol M Karmarkar; James E Graham; Anne Deutsch; Paulette Niewczyk; Margaret A DiVita; Kenneth J Ottenbacher Journal: Am J Phys Med Rehabil Date: 2013-01 Impact factor: 2.159