Article

OBJECTIVE: To examine the impact of Medicare's inpatient rehabilitation facility
(IRF) prospective payment system (PPS) on inpatient rehabilitation outcomes for
patients with traumatic spinal cord injury (SCI). DESIGN: Retrospective study.
SETTING: Twelve SCI Model Systems. PARTICIPANTS: A sample of Medicare (n=296) and
non-Medicare (n=3110) patients was selected from the National SCI Statistical
Center Database from 1996 to 2006. INTERVENTIONS: Not applicable. MAIN OUTCOME
MEASURES: Motor FIM score change and length of stay (LOS). RESULTS: LOS decreased
by about 5.8 days a year (P<.001) for Medicare patients and about 1.3 days a year
(P=.031) for non-Medicare patients after PPS implementation. However, for both
groups, FIM score gains were not significantly different in the pre-PPS and PPS
periods. CONCLUSIONS: Although significant decreases in LOS were observed for
Medicare patients after IRF PPS implementation, Medicare patients' improvements
in motor function did not decrease. Non-Medicare patients with SCI also
experienced shortened stays after Medicare IRF PPS implementation, but had
equivalent FIM score gains compared with their counterparts who received
inpatient rehabilitation care before PPS implementation. IRF PPS implementation
was associated with shorter stays, but was not associated with lower functional
improvement.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS