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To examine the association of inpatient rehabilitation facility (IRF) length of stay (LOS) with stroke patient outcomes. A secondary data analysis of the Uniform Data System for Medical Rehabilitation database. Stroke patients discharged from IRFs in the United States between 2009 and 2011 were identified and divided into mild (n = 639), moderate (n= 2,065), and severely (n= 2,077) impaired groups. Study outcomes included cognition and motor functional gains measured by the Functional Independence Measure (FIM) instrument and discharge to the community. The average LOSwas 8.9, 13.9, and 22.2 days for mild, moderate, and severely impaired stroke patients, respectively. After controlling for FIMadmission and other important covariates, a longer LOSwas associated with a modest increase in cognition gain (β = 0.038, p =.0045) for the moderately impaired patients, and a modest increase in cognition (β = 0.13, p <.0001) and motor gains (β = 0.25, p <.0001) as well as a tendency for discharge to the community (OR= 1.01, 95% CI= 1.00–1.02) among the severely impaired patients. However, a longer LOSshowed a negative association with functional gains among the mildly impaired patients as well as discharge to community for both mild and moderately impaired patients. The association of IRF LOSand patient outcomes varied by stroke impairment severity, positively for more severely impaired patients and negatively for mildly impaired patients. The study provides evidence for the care of stroke patients at the IRFsetting.

Identifying clinical data acquired at inpatient rehabilitation admission for stroke that accurately predict key outcomes at discharge could inform the development of customized plans of care to achieve favorable outcomes. The purpose of this analysis was to use a large comprehensive national data set to consider a wide range of clinical elements known at admission to identify those that predict key outcomes at rehabilitation discharge.

A preliminary investigation of the burn rehabilitation population found a large variability of zero onset day frequency between facilities. Onset days is defined as the time from injury to inpatient rehabilitation admission; this variable has not been investigated in burn patients previously. This study explored if this finding was a facility-based phenomena or characteristic of burn inpatient rehabilitation patients. This study was a secondary analysis of Uniform Data System for Medical Rehabilitation (UDSmr®) data from 2002 to 2007 examining inpatient rehabilitation characteristics among patients with burn injuries. Exclusion criteria were age less than 18 years and discharge against medical advice. Comparisons of demographic, medical and functional data were made between facilities with a high frequency of zero onset days versus facilities with a low frequency of zero onset days. A total of 4738 patients from 455 inpatient rehabilitation facilities were included. Twenty-three percent of the population exhibited zero onset days (n = 1103). Sixteen facilities contained zero onset patients; two facilities accounted for 97% of the zero onset subgroup. Facilities with a high frequency of zero onset day patients demonstrated significant differences in demographic, medical, and functional variables compared to the remainder of the study population. There were significantly more zero onset day admissions among burn patients (23%) than other diagnostic groups (0.5– 3.6%) in the Uniform Data System for Medical Rehabilitation database, but the majority (97%) came from two inpatient rehabilitation facilities. It is unexpected for patients with significant burn injury to be admitted to a rehabilitation facility on the day of injury. Future studies investigating burn rehabilitation outcomes using the Uniform Data System for Medical Rehabilitation database should exclude facilities with a high percentage of zero onset days, which are not representative of the burn inpatient rehabilitation population.

Transfer to acute care from rehabilitation represents an interruption in a patient’s recovery and a potential deficiency in quality of care. The objective of this study was to examine predictors of transfer to acute care in the inpatient burn rehabilitation population.

Advances in burn care in recent decades have resulted in a growing population of burn survivors and an increased need for inpatient rehabilitation. Burn survivors who require inpatient rehabilitation typically experience severe and complicated injuries. The purpose of this study is to examine burn rehabilitation outcomes and their predictor variables. Data are obtained from the Uniform Data System for Medical Rehabilitation from 2002 to 2007. Inclusion criterion is primary diagnosis of burn injury. Predictor variables include demographic, medical, and facility data. Outcome measures are length of stay efficiency, FIM® gain, community discharge, and FIM® discharge of at least 78. Linear and logistic regression analyses are used to determine significant predictors of outcomes. There are 2920 patients who meet inclusion criteria. The mean age of the population is 51 years, 33% of the population is female, 73% is Caucasian, and 40% are married. The median TBSA decile is 20 to 29%. The population exhibits a mean FIM® gain of 28 and length of stay efficiency of 2.1. A majority of the population is discharged to the community (76%) and has a FIM® discharge of at least 78 (81%). Significant predictors of outcomes in burn rehabilitation include age, FIM® admission, onset days, employment status, and marital status. Inpatient rehabilitation is critical to community reintegration of burn survivors. Survivors who are young, married, employed, and higher functioning at the time of admission to rehabilitation demonstrate the best outcomes. This research will help assess the rehabilitation potential of burn survivors and inform resource allocation.

To determine the psychometric properties of a new functional assessment tool, the WeeFIM 0-3 instrument, intended to measure function in young children with physical, cognitive, or developmental impairments from birth to 3 years of age. Specific aims were to determine whether differences exist in WeeFIM 0-3 ratings in children with impairments as compared with those without, controlling for age and gender, and to determine the internal consistency, validity, and hierarchical properties of the instrument.