Wagner Todd H, Richardson Samuel S, Vogel Bruce, Wing Kristen, Smith Mark W
Department of Veterans Affairs (VA) Health Economics Resource Center, Menlo Park, CA 94025, USA.
J Rehabil Res Dev. 2006 Nov-Dec;43(7):929-38. doi: 10.1682/jrrd.2005.10.0162.
We investigated the determinants of inpatient rehabilitation costs in the Department of Veterans Affairs (VA) and examined the relationship between length of stay (LOS) and discharge costs using data from VA and community rehabilitation hospitals. We estimated regression models to identify patient characteristics associated with specialized inpatient rehabilitation costs. VA data included 3,535 patients discharged from 63 facilities in fiscal year 2001. We compared VA costs to community rehabilitation hospitals using a sample from the Uniform Data System for Medical Rehabilitation of 190,112 patients discharged in 1999 from 697 facilities. LOS was a strong predictor of cost for VA and non-VA hospitals. Functional status, measured by Functional Independence Measure (FIM) scores at admission, was statistically significant but added little explanatory value after controlling for LOS. Although FIM scores were associated with LOS, FIM scores accounted for little variance in cost after controlling for LOS. These results are most applicable to researchers conducting cost-effectiveness analyses.
我们利用退伍军人事务部（VA）和社区康复医院的数据，调查了VA住院康复费用的决定因素，并研究了住院时间（LOS）与出院费用之间的关系。我们估计了回归模型，以确定与专科住院康复费用相关的患者特征。VA数据包括2001财年从63家机构出院的3535名患者。我们使用1999年从697家机构出院的190112名患者的统一医疗康复数据系统样本，将VA费用与社区康复医院进行了比较。LOS是VA医院和非VA医院费用的有力预测指标。入院时通过功能独立性测量（FIM）评分衡量的功能状态具有统计学意义，但在控制LOS后增加的解释价值不大。尽管FIM评分与LOS相关，但在控制LOS后，FIM评分在费用方面的方差占比很小。这些结果最适用于进行成本效益分析的研究人员。
