From the Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston (JEG, AMK, KJO); Uniform Data System for Medical Rehabilitation, Buffalo, New York (CVG, PN, MAD); Rehabilitation Institute of Chicago, Illinois (AD); Department of Physical Medicine and Rehabilitation and Institute for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (AD); and RTI International, Washington, DC (AD).
Am J Phys Med Rehabil. 2014 Mar;93(3):231-44. doi: 10.1097/PHM.0b013e3182a92c58.
The aim of this study was to present yearly aggregated summaries of rehabilitation outcomes at admission, discharge, and follow-up from a national sample of patients receiving inpatient medical rehabilitation for stroke, traumatic brain injury, lower extremity fracture, lower extremity joint replacement, traumatic spinal cord injury, or debility.
This is an analysis of secondary data from more than 300 inpatient rehabilitation facilities in the United States that contributed inpatient and follow-up data to the Uniform Data System for Medical Rehabilitation during the period January 2002 through December 2010. Aggregate variables reported include demographic information, social situation, and functional status (Functional Independence Measure instrument ratings at admission, discharge, and follow-up). Follow-up data were obtained 80-180 days after discharge through telephone interviews by trained clinical staff.
The final sample included 287,104 patients with follow-up information. The median time to follow-up was 95 days. Overall, more than 90% of the patients within each impairment group were living in the community at follow-up. Follow-up Functional Independence Measure total ratings were stable to slightly increased over time. Change scores (discharge to follow-up) increased in all six groups. The mean Functional Independence Measure gains from discharge to follow-up, as a percentage of mean gains from admission to discharge, varied by impairment category: 46% for spinal cord injury to 71% for lower extremity fracture. Locomotion yielded the lowest ratings at all three assessments within each of the six impairment groups.
The follow-up data from the national sample of patients discharged from inpatient rehabilitation indicate that gains in mean functional independence scores from both admission to discharge and discharge to follow-up gradually increased from 2002 to 2010. At follow-up, more than nine of ten patients in all six groups are living in the community.
本研究旨在呈现从全美接受住院医疗康复治疗的患者中选取的样本，按每年汇总的在入院、出院和随访时的康复结果摘要。这些患者分别患有脑卒中、创伤性脑损伤、下肢骨折、下肢关节置换、创伤性脊髓损伤或虚弱。
这是对美国 300 多家住院康复机构的二次数据进行的分析，这些机构在 2002 年 1 月至 2010 年 12 月期间向医疗康复统一数据系统提交了住院和随访数据。报告的汇总变量包括人口统计学信息、社会状况和功能状态（入院、出院和随访时的功能独立性测量仪评定等级）。通过训练有素的临床工作人员在出院后 80-180 天进行电话访谈，获取随访数据。
最终样本包括 287104 名有随访信息的患者。中位随访时间为 95 天。总体而言，每个损伤组内超过 90%的患者在随访时居住在社区中。随着时间的推移，随访时的功能独立性测量仪总评分保持稳定或略有增加。所有 6 个组的功能独立性测量仪评分从出院到随访时的变化评分（差值）都有所增加。从出院到随访时的功能独立性测量仪评分平均增益，占从入院到出院时平均增益的百分比，因损伤类别而异：脊髓损伤为 46%，下肢骨折为 71%。在 6 个损伤组的每个组中，在所有三个评估中，运动得分最低。
从全美出院患者的样本中获取的随访数据表明，从入院到出院和从出院到随访时，功能独立性评分的平均增益逐渐从 2002 年增加到 2010 年。在随访时，6 个组中超过十分之九的患者都居住在社区中。
