Abstract:
OBJECTIVES:To operationalize research findings about a medical rehabilitation classification and payment model by building a prototype of a prospective payment system, and to determine whether this prototype model promotes payment equity. This latter objective is accomplished by identifying whether any facility or payment model characteristics are systematically associated with financial performance. DESIGN:This study was conducted in two phases. In Phase 1 the components of a diagnosis-related group (DRG)-like payment system, including a base rate, function-related group (FRG) weights, and adjusters, were identified and estimated using hospital cost functions. Phase 2 consisted of a simulation analysis in which each facility's financial performance was modeled, based on its 1990-1991 case mix. A multivariate regression equation was conducted to assess the extent to which characteristics of 42 rehabilitation facilities contribute toward determining financial performance under the present Medicare payment system as well as under the hypothetical model developed. PARTICIPANTS:Phase 1 (model development) included 61 rehabilitation hospitals. Approximately 59% were rehabilitation units within a general hospital and 48% were teaching facilities. The number of rehabilitation beds averaged 52. Phase 2 of the stimulation analysis included 42 rehabilitation facilities, subscribers to UDS in 1990-1991. Of these, 69% were rehabilitation units and 52% were teaching facilities. The number of rehabilitation beds averaged 48. MAIN OUTCOME MEASURE:Financial performance, as measured by the ratio of reimbursement to average costs. RESULTS:Case-mix index is the primary determinant of financial performance under the present Medicare payment system. None of the facility characteristics included in this analysis were associated with financial performance under the hypothetical FRG payment model. CONCLUSIONS:The most notable impact of an FRG-based payment model would be to create a stronger link between resource intensity and level of reimbursement, resulting in greater equity in the reimbursement of inpatient medical rehabilitation hospitals.
journal_name
Arch Phys Med Rehabiljournal_title
Archives of physical medicine and rehabilitationauthors
Sutton JP,DeJong G,Song H,Wilkerson Ddoi
10.1016/s0003-9993(97)90299-9subject
Has Abstractpub_date
1997-12-01 00:00:00pages
1290-7issue
12eissn
0003-9993issn
1532-821Xpii
S0003-9993(97)90299-9journal_volume
78pub_type
杂志文章abstract::Compliance with regimens for chronic conditions such as juvenile rheumatoid arthritis (JRA) is often poor, and the potential benefits of therapy are thus compromised. In this study a compliance intervention involving educational and behavioral strategies was shown effective in improving medication compliance for two o...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1988-06-01 00:00:00
abstract::Dysphagia is a problem commonly treated and frequently diagnosed on the rehabilitation unit. It can be caused by trauma, injury, or diseases of the nervous system and can result in potentially serious and life threatening complications. The disruption of normal swallowing has also been reported to occur in psychiatric...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1993-04-01 00:00:00
abstract:OBJECTIVE:To investigate whether body weight-supported treadmill training (BWSTT) is of long-term benefit for patients with Parkinson's disease (PD). DESIGN:Randomized controlled trial. SETTING:Inpatient rehabilitation unit for neurologic diseases in Japan. PARTICIPANTS:Twenty-four patients (Hoehn and Yahr stages 2....
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.2002.34603
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:To describe recovery of gait after total hip arthroplasty (THA) based on the assessment of spatiotemporal gait parameters determined with an ambulatory system. DESIGN:A 6-month inception cohort study. SETTING:Inpatient and outpatient setting in an academic hospital. PARTICIPANTS:Sixty-three patients partic...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2006.11.026
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVE:To evaluate over a 2-year period the serial swallowing function of patients with nasopharyngeal carcinoma (NPC) after completing radiotherapy (RT). DESIGN:Prospective longitudinal follow-up. SETTING:University hospital. PARTICIPANTS:Patients with NPC (N=76) referred for RT: 53 of them at 1 year after RT, a...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2011.06.008
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVES:To assess upper-limb spasticity after stroke by means of clinical and instrumental tools and to identify possible variables influencing the clinical pattern. DESIGN:Descriptive measurement study of a consecutive sample of patients with upper-limb spasticity after stroke. SETTING:Neurorehabilitation hospita...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2004.10.022
更新日期:2005-03-01 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:OBJECTIVE:To test the feasibility of a classification system developed to record the contents of treatment sessions intended to improve mobility and self-care by persons with a spinal cord injury (SCI) in clinical rehabilitation. DESIGN:Descriptive study. SETTING:Three Dutch SCI facilities. PARTICIPANTS:Participants...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2007.12.044
更新日期:2008-08-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,多中心研究
doi:10.1016/j.apmr.2012.02.035
更新日期:2012-09-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVE:To determine outcomes after administration of a prone lumbar traction protocol. DESIGN:Prospective, longitudinal, case series. SETTING:Suburban, chiropractic practice. PARTICIPANTS:A total of 296 subjects with low back pain (LBP) and evidence of a degenerative and/or herniated intervertebral disk at 1 or m...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2007.06.778
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVE:To examine whether commonly used comorbidity indexes (Deyo-Charlson comorbidity index, Elixhauser comorbidity index, the Centers for Medicare and Medicaid Services [CMS] comorbidity tiers) capture comorbidities in the acute traumatic and nontraumatic SCI inpatient rehabilitation population. DESIGN:Retrospect...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2020.04.025
更新日期:2020-10-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.apmr.2012.07.020
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:To evaluate long-term outcomes of a noninvasive cortical stimulation technology in the treatment of fibromyalgia (FM). DESIGN:After trial follow-up survey of subjects who had completed a randomized, controlled, double-blind study of noninvasive cortical stimulation therapy some 45 months previously. SETTING...
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.2012.04.006
更新日期:2012-10-01 00:00:00
abstract::Spinal cord injured (SCI) patients are often placed on an intermittent catheterization (IC) program during their initial rehabilitation in an effort to establish a catheter-free state. A noninvasive method to quantitatively determine residual urine volumes would decrease unnecessary catheterizations and be useful in t...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1988-07-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2003.02.001
更新日期:2004-02-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,多中心研究
doi:10.1016/j.apmr.2019.02.016
更新日期:2019-11-01 00:00:00
abstract::This article presents a 3-part framework for developing and evaluating prediction models in rehabilitation populations. First, a process for developing and refining prognostic research questions and the scientific approach to prediction models is presented. Primary components of the scientific approach include the stu...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2012.04.021
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:To explore the effects on motor function and impairment of mobilization and tactile stimulation for the paretic arm and hand after stroke. DESIGN:Replicated single-system series, ABA design. SETTING:The stroke rehabilitation ward of a community hospital in the United Kingdom. PARTICIPANTS:Consecutive sampl...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2008.03.016
更新日期:2008-10-01 00:00:00
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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.2014.05.013
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVES:To identify factors relating to the intensity of rehabilitation services received and to ascertain the relation between injury outcomes, demographics, types of therapy, and the intensity of rehabilitation services provided. DESIGN:A multicenter, prospective, nonrandomized study with inpatient rehabilitation...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/s0003-9993(03)00272-7
更新日期:2003-10-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2007.11.025
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVE:To determine if constraint-induced movement therapy (CIMT) is more effective than bimanual training to improve occupational performance and participation in children with congenital hemiplegia. DESIGN:Single-blind randomized comparison trial with evaluations at baseline, 3, and 26 weeks. SETTING:Community f...
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.2010.11.022
更新日期:2011-04-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2007.11.050
更新日期:2008-07-01 00:00:00
abstract:OBJECTIVE:To examine the agreement of scores between the Disabilities of the Arm, Shoulder and Hand (DASH) and QuickDASH questionnaires in patients with distal radius fractures (DRFs) and their score's concurrent validity with Patient-Rated Wrist Evaluation (PRWE) scores. DESIGN:Validity study. SETTING:Hand and upper...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2016.11.023
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:To determine the interrater reliability of the Donovan system for classification of pain in spinal cord injury (SCI) as well as the clinician-based usefulness of each of the classification criteria used in the Donovan system. DESIGN:Information pertinent to the Donovan system was provided incrementally by vi...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1053/apmr.2002.33636
更新日期:2002-09-01 00:00:00
abstract::The response of geriatric patients to a multidisciplinary chronic pain rehabilitation program was measured by comparing outcome data on 17 older patients (55 to 78 years) to data on 20 younger patients (29 to 48 years) treated in the same program. Pretreatment data were obtained at an initial evaluation, and posttreat...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1988-12-01 00:00:00
abstract::This study examines the test-retest reliability of the ventilatory threshold (VT) and the maximum oxygen uptake (VO2max) in adults with cerebral palsy (CP). Nine subjects completed two continuous incremental tests on either a wheelchair ergometer (WE, n = 5) or a cycle ergometer (CE, n = 4) to volitional fatigue. Meta...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/0003-9993(94)90195-3
更新日期:1994-06-01 00:00:00
abstract:OBJECTIVES:The aims of the present systematic review and meta-analysis were to determine the relationship between muscular strength and all-cause mortality risk and to examine the sex-specific impact of muscular strength on all-cause mortality in an apparently healthy population. DATA SOURCES:Two authors systematicall...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,meta分析
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更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:To determine if patients' level of effort (LOE) in therapy sessions during traumatic brain injury (TBI) rehabilitation modifies the effect of compliance with the 3-Hour Rule of the Centers for Medicare & Medicaid Services. DESIGN:Propensity score methodology applied to the TBI Practice-Based Evidence databas...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2019.01.014
更新日期:2019-10-01 00:00:00