Rehabilitation outcomes among burn injury patients with asecond admission to an inpatient rehabilitation facility

Margaret A. DiVita, Jacqueline M. Mix, Richard Goldstein, Paul Gerrard, Paulette Niewczyk, Colleen M. Ryan, Karen Kowalske, Ross Zafonte, Jeffrey C. Schneider

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Abstract

Background: Burn survivors tend to have complex medical issues requiring rehabilitation to improve overall function and quality of life. A subset of burn patients treated in inpatient rehabilitation facilities (IRFs) may require more than 1 rehabilitation stay for the same injury. Objective: To compare the rehabilitation outcomes among burn patients admitted to an IRF who were discharged to acute care and then readmitted to an IRF with burn patients admitted to an IRF only 1 time. Design: Retrospective cohort study. Setting: Inpatient rehabilitation facilities. Participants: Burn injury patients aged 18 years or more who were admitted to IRFs between 2002 and 2011. Methods: We performed a secondary analysis of data from Uniform Data System for Medical Rehabilitation, a national data repository. Outcomes of the repeaters' second stay (n= 188) were compared to the nonrepeaters' first and only stay (n= 6,855), using linear regression and logistic regression to determine whether repeater status was associated with rehabilitation outcomes. Main Outcome Measurements: Functional status (using the Functional Independence Measure [FIM] instrument) at admission, discharge and change, length of stay, FIM efficiency (total FIM points gained per day), and discharge disposition. Results: Repeater status was inversely associated with discharge FIM total (coefficient=-3.42, 95% confidence interval=-5.76,-1.07) and FIM change (coefficient=-4.05, 95% CI=-6.34,-1.75) in linear regression models. No other significant differences were found, and those differences in discharge FIM total and FIM change were small. Conclusions: Differences found in rehabilitation outcomes between the repeater and nonrepeater groups were small and may not reflect clinically meaningful differences. Burn injury patients who required a second IRF admission had rehabilitation outcomes similar tothose of burn injury patients who did not require a second IRF admission, emphasizing the value of inpatient rehabilitation for burn injury IRF readmissions.

Original languageEnglish (US)
Pages (from-to)999-1007
Number of pages9
JournalPM and R
Volume6
Issue number11
DOIs
StatePublished - Nov 1 2014

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Inpatients
Rehabilitation
Wounds and Injuries
Linear Models
Information Systems
Survivors
Length of Stay
Cohort Studies
Retrospective Studies
Logistic Models
Quality of Life
Confidence Intervals

ASJC Scopus subject areas

  • Rehabilitation
  • Neurology
  • Clinical Neurology
  • Physical Therapy, Sports Therapy and Rehabilitation

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DiVita, M. A., Mix, J. M., Goldstein, R., Gerrard, P., Niewczyk, P., Ryan, C. M., ... Schneider, J. C. (2014). Rehabilitation outcomes among burn injury patients with asecond admission to an inpatient rehabilitation facility. PM and R, 6(11), 999-1007. https://doi.org/10.1016/j.pmrj.2014.05.010

Rehabilitation outcomes among burn injury patients with asecond admission to an inpatient rehabilitation facility. / DiVita, Margaret A.; Mix, Jacqueline M.; Goldstein, Richard; Gerrard, Paul; Niewczyk, Paulette; Ryan, Colleen M.; Kowalske, Karen; Zafonte, Ross; Schneider, Jeffrey C.

In: PM and R, Vol. 6, No. 11, 01.11.2014, p. 999-1007.

Research output: Contribution to journalArticle

DiVita, MA, Mix, JM, Goldstein, R, Gerrard, P, Niewczyk, P, Ryan, CM, Kowalske, K, Zafonte, R & Schneider, JC 2014, 'Rehabilitation outcomes among burn injury patients with asecond admission to an inpatient rehabilitation facility', PM and R, vol. 6, no. 11, pp. 999-1007. https://doi.org/10.1016/j.pmrj.2014.05.010
DiVita, Margaret A. ; Mix, Jacqueline M. ; Goldstein, Richard ; Gerrard, Paul ; Niewczyk, Paulette ; Ryan, Colleen M. ; Kowalske, Karen ; Zafonte, Ross ; Schneider, Jeffrey C. / Rehabilitation outcomes among burn injury patients with asecond admission to an inpatient rehabilitation facility. In: PM and R. 2014 ; Vol. 6, No. 11. pp. 999-1007.
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abstract = "Background: Burn survivors tend to have complex medical issues requiring rehabilitation to improve overall function and quality of life. A subset of burn patients treated in inpatient rehabilitation facilities (IRFs) may require more than 1 rehabilitation stay for the same injury. Objective: To compare the rehabilitation outcomes among burn patients admitted to an IRF who were discharged to acute care and then readmitted to an IRF with burn patients admitted to an IRF only 1 time. Design: Retrospective cohort study. Setting: Inpatient rehabilitation facilities. Participants: Burn injury patients aged 18 years or more who were admitted to IRFs between 2002 and 2011. Methods: We performed a secondary analysis of data from Uniform Data System for Medical Rehabilitation, a national data repository. Outcomes of the repeaters' second stay (n= 188) were compared to the nonrepeaters' first and only stay (n= 6,855), using linear regression and logistic regression to determine whether repeater status was associated with rehabilitation outcomes. Main Outcome Measurements: Functional status (using the Functional Independence Measure [FIM] instrument) at admission, discharge and change, length of stay, FIM efficiency (total FIM points gained per day), and discharge disposition. Results: Repeater status was inversely associated with discharge FIM total (coefficient=-3.42, 95{\%} confidence interval=-5.76,-1.07) and FIM change (coefficient=-4.05, 95{\%} CI=-6.34,-1.75) in linear regression models. No other significant differences were found, and those differences in discharge FIM total and FIM change were small. Conclusions: Differences found in rehabilitation outcomes between the repeater and nonrepeater groups were small and may not reflect clinically meaningful differences. Burn injury patients who required a second IRF admission had rehabilitation outcomes similar tothose of burn injury patients who did not require a second IRF admission, emphasizing the value of inpatient rehabilitation for burn injury IRF readmissions.",
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AU - DiVita, Margaret A.

AU - Mix, Jacqueline M.

AU - Goldstein, Richard

AU - Gerrard, Paul

AU - Niewczyk, Paulette

AU - Ryan, Colleen M.

AU - Kowalske, Karen

AU - Zafonte, Ross

AU - Schneider, Jeffrey C.

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N2 - Background: Burn survivors tend to have complex medical issues requiring rehabilitation to improve overall function and quality of life. A subset of burn patients treated in inpatient rehabilitation facilities (IRFs) may require more than 1 rehabilitation stay for the same injury. Objective: To compare the rehabilitation outcomes among burn patients admitted to an IRF who were discharged to acute care and then readmitted to an IRF with burn patients admitted to an IRF only 1 time. Design: Retrospective cohort study. Setting: Inpatient rehabilitation facilities. Participants: Burn injury patients aged 18 years or more who were admitted to IRFs between 2002 and 2011. Methods: We performed a secondary analysis of data from Uniform Data System for Medical Rehabilitation, a national data repository. Outcomes of the repeaters' second stay (n= 188) were compared to the nonrepeaters' first and only stay (n= 6,855), using linear regression and logistic regression to determine whether repeater status was associated with rehabilitation outcomes. Main Outcome Measurements: Functional status (using the Functional Independence Measure [FIM] instrument) at admission, discharge and change, length of stay, FIM efficiency (total FIM points gained per day), and discharge disposition. Results: Repeater status was inversely associated with discharge FIM total (coefficient=-3.42, 95% confidence interval=-5.76,-1.07) and FIM change (coefficient=-4.05, 95% CI=-6.34,-1.75) in linear regression models. No other significant differences were found, and those differences in discharge FIM total and FIM change were small. Conclusions: Differences found in rehabilitation outcomes between the repeater and nonrepeater groups were small and may not reflect clinically meaningful differences. Burn injury patients who required a second IRF admission had rehabilitation outcomes similar tothose of burn injury patients who did not require a second IRF admission, emphasizing the value of inpatient rehabilitation for burn injury IRF readmissions.

AB - Background: Burn survivors tend to have complex medical issues requiring rehabilitation to improve overall function and quality of life. A subset of burn patients treated in inpatient rehabilitation facilities (IRFs) may require more than 1 rehabilitation stay for the same injury. Objective: To compare the rehabilitation outcomes among burn patients admitted to an IRF who were discharged to acute care and then readmitted to an IRF with burn patients admitted to an IRF only 1 time. Design: Retrospective cohort study. Setting: Inpatient rehabilitation facilities. Participants: Burn injury patients aged 18 years or more who were admitted to IRFs between 2002 and 2011. Methods: We performed a secondary analysis of data from Uniform Data System for Medical Rehabilitation, a national data repository. Outcomes of the repeaters' second stay (n= 188) were compared to the nonrepeaters' first and only stay (n= 6,855), using linear regression and logistic regression to determine whether repeater status was associated with rehabilitation outcomes. Main Outcome Measurements: Functional status (using the Functional Independence Measure [FIM] instrument) at admission, discharge and change, length of stay, FIM efficiency (total FIM points gained per day), and discharge disposition. Results: Repeater status was inversely associated with discharge FIM total (coefficient=-3.42, 95% confidence interval=-5.76,-1.07) and FIM change (coefficient=-4.05, 95% CI=-6.34,-1.75) in linear regression models. No other significant differences were found, and those differences in discharge FIM total and FIM change were small. Conclusions: Differences found in rehabilitation outcomes between the repeater and nonrepeater groups were small and may not reflect clinically meaningful differences. Burn injury patients who required a second IRF admission had rehabilitation outcomes similar tothose of burn injury patients who did not require a second IRF admission, emphasizing the value of inpatient rehabilitation for burn injury IRF readmissions.

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