Characteristics of cost outliers who did not benefit from stroke rehabilitation

American Journal of Physical Medicine & Rehabilitation
J S OsbergG DeJong

Abstract

The purpose of this paper is twofold: 1) to identify stroke patients who generated substantial charges during inpatient rehabilitation, but did not seem to benefit from that experience and 2) to identify factors that can predict which patients will fall into this group using only variables known at admission to rehabilitation. High cost stroke patients during inpatient medical rehabilitation are examined to determine how they differ from low cost patients and to identify a subset who did not appear to benefit from rehabilitation. This paper is based on longitudinal charge data involving 73 former stroke rehabilitation patients discharged from three Boston area rehabilitation facilities in 1984. Medical charges are presented on initial acute and rehabilitation inpatient stays and on care received in the 12 months after discharge. Among these 73 stroke patients, charges for inpatient medical rehabilitation amounted to nearly 1.8 million dollars, excluding physician fees and out-of-pocket expenses. Of this total, 57.6% was accured by only 33% of the patients. Fourteen patients, who were both rehabilitation cost outliers and apparent rehabilitation "failures," were identified. Rehabilitation charges for these 14 amounted to $673,23...Continue Reading

Citations

Jan 1, 1997·Rehabilitation Nursing : the Official Journal of the Association of Rehabilitation Nurses·I D MontoyaW A Goodpastor
Oct 2, 2007·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Sean J PittockJoan T Moroney
Jan 1, 1993·Postgraduate Medical Journal·L KalraP Crome
May 1, 1993·Rehabilitation Nursing : the Official Journal of the Association of Rehabilitation Nurses·D RagsdaleA T Lasher
Apr 13, 2010·Disability and Rehabilitation·William J Taylor, George Laking
Nov 20, 1998·Archives of Physical Medicine and Rehabilitation·R L HarveyS Diaz
May 11, 2001·Archives of Physical Medicine and Rehabilitation·B RybarczykJ J Nicholas
Apr 1, 1997·Topics in Stroke Rehabilitation·D C Strasser, J A Falconer
Apr 1, 1993·Journal of the American Geriatrics Society·L Kalra, P Crome
May 11, 2001·Archives of Physical Medicine and Rehabilitation·D D CardenasS M Gnatz
Mar 1, 1997·Stroke; a Journal of Cerebral Circulation·N E MayoS C Scott
Dec 26, 2008·Stroke; a Journal of Cerebral Circulation·Ramon Luengo-FernandezPeter M Rothwell

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