Abstract：
:Since 1993, the numbers of hip and knee replacements in the United States have increased 2-fold to 3-fold while lengths of stay in acute care have decreased by about half, leading to a significant growth in the use of postacute rehabilitative care for patients with a joint replacement. To document these trends, this article uses secondary analysis of acute hospital discharge survey data and evaluates projections to 2030. This article uses a market approach to identify 3 sets of factors that influence the use of joint replacements: (1) increasing patient demand, (2) increasing supply of practitioners, and (3) the role of fiscal intermediaries. The article reviews underlying epidemiologic trends, growing numbers of orthopedic surgeons performing the procedure, technologic innovations, changing indications for the procedure, changing payer mix, and the effects of payer attempts to contain joint replacement costs. An unintended effect of Medicare payment policy has been to shift costs from acute care to downstream postacute care. Medicare and private health plan reimbursement policies need to take into account this broader perspective and not examine joint replacement care and payment in isolated care settings. Future research and health policy needs to consider the interdependent features of the health care system by linking changes in postacute care with upstream changes both in society at large and in the organization, delivery, and financing of acute care associated with joint replacement.
journal_name
Arch Phys Med Rehabiljournal_title
Archives of physical medicine and rehabilitationauthors
Tian W,DeJong G,Brown M,Hsieh CH,Zamfirov ZP,Horn SDdoi
10.1016/j.apmr.2008.10.035subject
Has Abstractpub_date
2009-08-01 00:00:00pages
1260-8issue
8eissn
0003-9993issn
1532-821Xpii
S0003-9993(09)00306-2journal_volume
90pub_type
杂志文章abstract：:Because the acute spinal cord injured patient is at high risk for the development of deep venous thrombosis (DVT), accurate diagnosis is critical. Clinical evaluation is unreliable 50% of the time, however, and the two highly accurate diagnostic procedures--venography and 125I-labelled fibrinogen scanning--are invasiv...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1985-06-01 00:00:00
abstract：:Understanding the use of weights in the analysis of data from multistage surveys. Large national surveys are powerful tools with which to examine a variety of important rehabilitation-related issues and are currently the only feasible method to study disability trends over time. Because it is impractical to draw simpl...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2005.09.021
更新日期：2006-02-01 00:00:00
abstract：OBJECTIVE:To investigate the postural alignment of the upper body in the sagittal plane during sitting and standing postures as pregnancy progressed and then in the postpartum period. DESIGN:Longitudinal, repeated-measures design. SETTING:Biomechanics laboratory in an Australian university. PARTICIPANTS:A volunteer ...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1053/apmr.2002.36069
更新日期：2002-12-01 00:00:00
abstract：:A vexing issue in disability research today is the specification and measurement of long-term outcome measures relevant to the evaluation of independent living (IL) programs and services. The purpose of this article is to present 2 long-term outcome measures that are sensitive to both the philosophy of the IL movement...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1982-02-01 00:00:00
abstract：OBJECTIVE:To compare a commercially available electric muscle stimulation regimen with a novel form of stimulation for the rehabilitation of the quadriceps muscle, in patients with patellofemoral pain syndrome. DESIGN:Double-blinded randomized trial with a parallel control group and stratified randomization. SETTING:...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/j.apmr.2003.07.021
更新日期：2004-06-01 00:00:00
abstract：OBJECTIVE:To determine whether family functioning is uniquely associated with caregiver depressive symptoms in the immediate aftermath of stroke. DESIGN:Cross-sectional data from the baseline assessment of an intervention study for stroke survivors and their families. SETTING:Neurology inpatient service of a large ur...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2008.12.014
更新日期：2009-06-01 00:00:00
abstract：:A case study is presented of a 64-year-old, right-handed, congenitally deaf man who suffered a single, unilateral, left CVA resulting in a right hemiplegia and moderate aphasia. The relationship between his verbal (reading and writing), manual, and pantomimic performances is examined in two ways. First, a comparison o...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1989-02-01 00:00:00
abstract：OBJECTIVE:To test the hypothesis that use of a cane in the nondominant hand during challenging balance tasks would significantly decrease loss of balance in patients with peripheral neuropathy while transferring from bipedal to unipedal stance on an unsteady surface. DESIGN:Nonrandomized control study. SETTING:Tertia...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/s0003-9993(96)90032-5
更新日期：1996-05-01 00:00:00
abstract：OBJECTIVE:To investigate the relationship between sedentary behavior and quality-adjusted life years (QALYs) among participants in the Osteoarthritis Initiative. DESIGN:Longitudinal, observational design. SETTING:Osteoarthritis Initiative cohort. PARTICIPANTS:Individuals (N=1794) from a prospective, multicenter long...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,多中心研究
doi：10.1016/j.apmr.2017.06.004
更新日期：2017-12-01 00:00:00
abstract：OBJECTIVE:To investigate the effect of ramelteon on sleep and daytime functioning among individuals with traumatic brain injury (TBI). DESIGN:A double-blind, placebo-controlled study with a crossover design. SETTING:A research facility attached to an acute rehabilitation hospital. PARTICIPANTS:Individuals with TBI (...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.apmr.2015.05.011
更新日期：2015-10-01 00:00:00
abstract：:Twenty-nine C4 to C7 motor-complete spinal cord injured subjects were evaluated to determine whether the manual muscle test (MMT) performed within 24 hours of injury or at 72 hours after injury better predicts short-term functional muscle recovery. A single muscle in the zone of injury that had a muscle grade between ...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1991-07-01 00:00:00
abstract：:Energy expended while walking is increased for children with cerebral palsy compared to nondisabled children. This study compared oxygen uptake, oxygen pulse, and the respiratory exchange ratio (RER) in children with cerebral palsy and nondisabled children walking on a treadmill. Resting oxygen uptake and oxygen pulse...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/0003-9993(93)90029-a
更新日期：1993-07-01 00:00:00
abstract：OBJECTIVE:To investigate the course of mechanical efficiency of handrim wheelchair propulsion during rehabilitation of subjects with (in)complete paraplegia and tetraplegia. DESIGN:Subjects were tested at the start of active rehabilitation (t1), 3 months later (t2), and when discharged from inpatient rehabilitation (t...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,多中心研究
doi：10.1016/j.apmr.2004.11.025
更新日期：2005-07-01 00:00:00
abstract：:Heart rate (HR) and blood pressure (BP) responses to repeated dynamic and combined dynamic and isometric work bouts of 30 sec, 2 min, and 6 min with equal rest periods at 40% and 80% of Vo2max was studied in five healthy men and five healthy women. Total work duration for each experimental condition was 24 min. The tr...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1985-06-01 00:00:00
abstract：:Sporadic cases of recovery from persistent vegetative state (PVS) after administration of intrathecal baclofen (ITB) have been reported without giving any possible explanation for its paradoxical effect. We summarize our recent findings on 5 patients with PVS treated with ITB and make some speculations on the mechanis...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2009.01.012
更新日期：2009-07-01 00:00:00
abstract：OBJECTIVE:To report the efficacy of injected liquid silicone (ILS) in the foot at 2 years after administration. DESIGN:Randomized controlled trial. SETTING:Diabetic foot clinic in the United Kingdom. PARTICIPANTS:Twenty-eight diabetic neuropathic patients, randomized into an active treatment group (n=14) and a place...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1053/apmr.2002.33058
更新日期：2002-07-01 00:00:00
abstract：OBJECTIVE:To determine how total physical rehabilitation needs have been distributed per relevant condition groups (musculoskeletal and pain, neurologic cardiothoracic, neoplasms, pediatric, human immunodeficiency virus [HIV] related), globally and across countries of varying income level. DESIGN:Subgroup, secondary a...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2019.12.020
更新日期：2020-06-01 00:00:00
abstract：OBJECTIVES:Work-related components are an essential part of rehabilitation programs to support return to work of patients with musculoskeletal disorders. In Germany, a guideline for work-related medical rehabilitation was developed to increase work-related treatment components. In addition, new departments were approve...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 临床试验,杂志文章
doi：10.1016/j.apmr.2018.06.018
更新日期：2018-12-01 00:00:00
abstract：:Limited guidelines exist for rehabilitation programs for individuals with diabetes mellitus, blindness, and associated autonomic neuropathy. Abnormalities in autonomic function have been postulated to interfere with exercise conditioning and may predispose individuals to exercise-induced hypoglycemia. Twenty-nine indi...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1989-08-01 00:00:00
abstract：OBJECTIVE:To examine the relation between pain on weight bearing, lower-extremity muscle strength, and physical function among older Mexican Americans. DESIGN:Cross-sectional study. SETTING:Five Southwestern states: Texas, New Mexico, Colorado, Arizona, and California. PARTICIPANTS:A population-based sample of 544 n...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2004.12.038
更新日期：2005-07-01 00:00:00
abstract：OBJECTIVE:To evaluate the effectiveness of reinforced feedback in virtual environment (RFVE) treatment combined with conventional rehabilitation (CR) in comparison with CR alone, and to study whether changes are related to stroke etiology (ie, ischemic, hemorrhagic). DESIGN:Randomized controlled trial. SETTING:Hospit...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.apmr.2018.01.023
更新日期：2018-05-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to determine in Parkinson disease the impact of pulmonary dysfunction on daily living activities (DLA). PATIENTS:Extrapyramidal motor impairment, pulmonary dysfunction, and DLA disabilities were studied in 58 Parkinson patients consecutively enrolled in a rehabilitation service ...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/s0003-9993(96)90216-6
更新日期：1996-01-01 00:00:00
abstract：OBJECTIVE:To determine bone mineral density (BMD) z scores in adults with cerebral palsy (CP), an understudied population. DESIGN:Cross-sectional. SETTING:Medical facility. PARTICIPANTS:Adults (N=48; mean age, 34.3±5.8y; range, 25-46y) with CP. INTERVENTIONS:Not applicable. MAIN OUTCOME MEASURES:BMD z scores at th...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2015.03.012
更新日期：2015-07-01 00:00:00
abstract：:The functional effects of three types of therapy for subjects with long-term incomplete cervical spinal cord injuries were investigated. Men and women, aged 18 to 45 years, were assigned to one of four groups using a restricted randomization process. The training period was divided into two consecutive eight-week time...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1990-08-01 00:00:00
abstract：OBJECTIVE:To assess whether, and to what extent, cognitive outcome relates to overall functional outcome among elderly stroke patients. DESIGN:Nonconcurrent prospective study. SETTING:Geriatric rehabilitation division at a large, urban, academic, freestanding hospital in Israel. PARTICIPANTS:Three hundred thirty-six...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1053/apmr.2002.32739
更新日期：2002-06-01 00:00:00
abstract：OBJECTIVE:To identify instruments that measure community participation in people with disabilities and to evaluate which domains, to what extent, and how precisely they address this construct. The review aims to provide information to guide the selection of community participation instruments and to identify limitation...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.apmr.2012.10.031
更新日期：2013-04-01 00:00:00
abstract：:Several nations currently share a major concern for provision of services to severely disabled persons. The focus of this concern has been upon those services which promote maximum integration and independence of severely disabled individuals in the community. Recent efforts in this direction by governments, private c...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1979-10-01 00:00:00
abstract：OBJECTIVES:To determine which outcome measures are best and least suited for assessing long-term functional outcome of individuals with traumatic brain injury (TBI) in the community. DESIGN:Survey of participants in the community an average of 5 years after TBI. A battery of outcome measures was given. SETTING:Commun...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1053/apmr.2001.21525
更新日期：2001-03-01 00:00:00
abstract：OBJECTIVE:To describe the relationship between knee extension force and stand-up performance. DESIGN:Prospective, cross-sectional, descriptive, and correlational. SETTING:Community. PARTICIPANTS:Fifty-five community-dwelling women 60 or more years old. INTERVENTIONS:Information pertaining to stand-up performance wa...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1053/apmr.2001.26811
更新日期：2001-12-01 00:00:00
abstract：OBJECTIVES:To compare the measurement properties and responsiveness to change of the Patient Health Questionnaire-9 (PHQ-9), the Hopkins Symptom Checklist-20 (HSCL-20), and the Hamilton Depression Rating Scale (HAM-D) in people with spinal cord injury (SCI) diagnosed with major depressive disorder (MDD). DESIGN:Second...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.apmr.2016.01.017
更新日期：2016-06-01 00:00:00
