The Uniform Data System for Medical Rehabilitation

Granger CV, Markello SJ, Graham JE, Deutsch A, Reistetter TA, Ottenbacher KJ: The uniform data system for medical rehabilitation: Report of patients with lower limb joint replacement discharged from rehabilitation programs in 2000-2007. Am J Phys Med Rehabil 2010; 89: 781-794. Objective: To provide benchmarking information from a large national sample of patients receiving inpatient rehabilitation after lower limb joint replacement. Design: Secondary data analysis from 893 medical rehabilitation facilities located in the United States that contributed information to the Uniform Data System for Medical Rehabilitation from January 2000 through December 2007. Variables analyzed included demographic information (age, sex, marital status, race/ethnicity, prehospital living setting, discharge setting), hospitalization information (length of stay, program interruptions, payer, onset date, rehabilitation impairment group, International Classification of Diseases, 9th revision codes for admitting diagnosis, comorbidities), and functional status information (FIM instrument ["FIM"] ratings at admission and discharge, FIM efficiency, FIM gain). Results: Descriptive statistics from 705,345 patients showed an overall mean length of stay of 8.9 (+/- 4.7) days. FIM total admission and discharge ratings declined during the 8-yr study period. Mean admission ratings decreased from 83.5 (+/- 11.3) to 73.2 (+/- 12.9). Mean discharge ratings decreased from 108.4 (+/- 11.0) to 101.7 (+/- 12.9). Conversely, mean FIM change increased from 24.9 (+/- 9.2) to 28.6 (+/- 12.2). The percent of persons discharged to the community decreased from 94.5% to 91.9%. All results are likely to be influenced by various policy changes affecting classification or documentation processes or both. Conclusions: National rehabilitation data from persons with lower limb joint replacement in 2000-2007 indicate that inpatient rehabilitation lengths of stay have remained relatively stable and that patients are experiencing improvements in functional independence during their stay. In addition, more than 9 of 10 patients are discharged to community settings after inpatient rehabilitation.