当前位置： SCI文献检索 > ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION期刊下所有文献 > The effect of the introduction of a case-mix-based funding model of rehabilitation for severe stroke: an Australian experience.

The effect of the introduction of a case-mix-based funding model of rehabilitation for severe stroke: an Australian experience.

Abstract：

OBJECTIVE:To compare resource use of, and outcomes for, rehabilitation for severe stroke before and after the implementation of the Casemix and Rehabilitation Funding Tree case-mix-based funding model. DESIGN:Prospective, observational cohort study. SETTING:Eight inpatient rehabilitation centers in Australia. PARTICIPANTS:Consecutive sample of 609 patients with severe stroke. INTERVENTIONS:Not applicable. MAIN OUTCOME MEASURES:Rehabilitation length of stay (LOS), discharge destination, and FIM instrument motor score at discharge. RESULTS:The average rehabilitation LOS changed significantly between the preimplementation year and the implementation year (Mann-Whitney U, P=.001). There were no significant differences in discharge destination. FIM motor score at discharge showed significant reduction in improvement (Mann-Whitney U, P=.001) between the preimplementation year and the implementation year. There were no significant correlations between LOS in rehabilitation and gain in function for either the preimplementation year (Spearman rho, P=.07) or the implementation year (P=.15). CONCLUSIONS:The change in funding model was associated with a decrease in inpatient costs and with an associated increase in disability at discharge. Our results suggest that the rate of improvement in severe stroke is variable; also, they support the use of funding models for stroke rehabilitation that allow flexibility in resource allocation.

journal_name

Arch Phys Med Rehabil

journal_title

Archives of physical medicine and rehabilitation

authors

Brock KA,Vale SJ,Cotton SM

doi

10.1016/j.apmr.2007.04.001

subject

Has Abstract

pub_date

2007-07-01 00:00:00

pages

827-32

issue

7

eissn

0003-9993

issn

1532-821X

pii

S0003-9993(07)00289-4

journal_volume

88

pub_type

杂志文章,多中心研究

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