Kulp C S, O'Leary A A, Wegener S T, Fang W L, Brunner C M
Rehabilitation Research and Training Center, School of Medicine, University of Virginia, Charlottesville 22908.
Arch Phys Med Rehabil. 1988 Oct;69(10):873-6.
The implementation of prospective payment systems has severely limited the traditional practice of providing rehabilitation services to arthritis patients on rheumatic disease units; however, the admission of these patients to a designated rehabilitation unit may be appropriate. This paper presents data on the provision of inpatient rehabilitation services to patients with arthritis. Two surveys were developed for this study. The first survey sample consisted of 502 hospitals; 163 (52%) of the 313 respondents were identified as facilities providing inpatient arthritis rehabilitation. A second survey regarding patient and program characteristics was completed by 146 of the 313 facilities. The data from rehabilitation units serving arthritis patients are presented with regard to utilization, discharge disposition, sources of payment, patient demographic and diagnostic information, and specialization of the rehabilitation program. The data indicate that persons with arthritis are underrepresented in the rehabilitation population, although the diagnosis is approved for admission under rehabilitation guidelines. This underutilization is attributed to problems of reimbursement, inappropriate admission criteria, inadequately trained staff, and lack of referrals.
前瞻性支付系统的实施严重限制了在风湿性疾病科室为关节炎患者提供康复服务的传统做法;然而,将这些患者收治到指定的康复科室可能是合适的。本文展示了为关节炎患者提供住院康复服务的数据。为此研究开发了两项调查。第一项调查样本包括502家医院;313名受访者中的163家(52%)被确定为提供住院关节炎康复服务的机构。313家机构中的146家完成了第二项关于患者和项目特征的调查。呈现了为关节炎患者提供服务的康复科室的数据,内容涉及利用率、出院处置、支付来源、患者人口统计学和诊断信息以及康复项目的专业化情况。数据表明,尽管根据康复指南该诊断被批准入院,但关节炎患者在康复人群中的占比不足。这种利用不足归因于报销问题、不适当的入院标准、工作人员培训不足以及缺乏转诊。