脊髓损伤后对医学康复的满意度。

Tooth Leigh R, Ottenbacher Kenneth J, Smith Pamela M, Illig Sandra B, Linn Richard T, Granger Carl V

School of Population Health, University of Queensland, Brisbane, Australia.

Spine (Phila Pa 1976). 2004 Jan 15;29(2):211-9; discussion 219. doi: 10.1097/01.BRS.0000107236.74004.31.

STUDY DESIGN

Retrospective.

OBJECTIVE

To predict satisfaction with medical rehabilitation.

SUMMARY OF BACKGROUND DATA

While spinal cord injury (SCI) patient satisfaction with life and community services has been investigated, satisfaction with medical rehabilitation has not.

METHODS

Information submitted to the Uniform Data System for Medical Rehabilitation (1998-2001) by 134 hospitals/rehabilitation facilities in the United States (n = 6,205 patients with SCI) was examined. Predictors were sociodemographic variables, Case Mix Groupings (CMG) (401-505, 5001), length of stay, rehospitalization, follow-up therapy, and health maintenance. Satisfaction was assessed at a mean of 92.2 days (SD 11.9 days) postdischarge. Data were analyzed according to who reported the outcome (patient, n = 3,858 or family/other, n = 1,869). Statistical modeling was conducted using logistic regression.

RESULTS

High overall satisfaction was reported (94%). Significant predictors for the patient report data were CMG and rehospitalization. Compared with CMG 5001 (short stay, <3 days), patients in CMGs 401/2/3 and 501/2/3/4/5 had a 54% to 74% lower likelihood of being dissatisfied. Rehospitalized patients had a higher likelihood of dissatisfaction (odds ratio 2.3, 95% confidence interval 1.7 to 3.2). Significant predictors for the family/other report data were CMG (compared to CMG 5001, CMGs 401/2, 403, and 501/2 had a 70% lower likelihood of dissatisfaction), rehospitalization (odds ratio 1.7, 95% confidence interval 1.1-2.5), and marital status (married = 50% lower likelihood of dissatisfaction, 95% confidence interval 0.26-0.96).

CONCLUSIONS

Satisfaction with medical rehabilitation services following SCI is related to functional abilities, rehospitalization, and marital status. Slightly different results were found for whether satisfaction was rated by the patient or family/other. The complex relationships among satisfaction, patient demographics, and functional status require continued examination.

研究设计

回顾性研究。

目的

预测对医学康复的满意度。

背景数据总结

虽然已经对脊髓损伤（SCI）患者对生活和社区服务的满意度进行了调查，但对医学康复的满意度尚未进行调查。

方法

检查了美国134家医院/康复机构提交给医学康复统一数据系统（1998 - 2001年）的信息（n = 6205例SCI患者）。预测因素包括社会人口统计学变量、病例组合分组（CMG）（401 - 505，5001）、住院时间、再次住院、后续治疗和健康维护。出院后平均92.2天（标准差11.9天）评估满意度。根据报告结果的人（患者，n = 3858或家属/其他人，n = 1869）对数据进行分析。使用逻辑回归进行统计建模。

结果

报告的总体满意度较高（94%）。患者报告数据的显著预测因素是CMG和再次住院。与CMG 5001（短期住院，<3天）相比，CMG 401/2/3和501/2/3/4/5的患者不满意的可能性降低了54%至74%。再次住院的患者不满意的可能性更高（优势比2.3，95%置信区间1.7至3.2）。家属/其他人报告数据的显著预测因素是CMG（与CMG 5001相比，CMG 401/2、403和501/2不满意的可能性降低70%）、再次住院（优势比1.7，95%置信区间1.1 - 2.5）和婚姻状况（已婚=不满意的可能性降低50%，95%置信区间0.26 - 0.96）。