Efficiency of specialist rehabilitation in reducing dependency and costs of continuing care for adults with complex acquired brain injuries.

Journal of Neurology, Neurosurgery, and Psychiatry
L Turner-StokesH Williams

Abstract

To examine functional outcomes from a rehabilitation programme and to compare two methods for evaluating cost efficiency of rehabilitation in patients with severe complex disability. Two hundred and ninety seven consecutive admissions to a specialist inpatient rehabilitation unit following severe acquired brain injury. Retrospective analysis of routinely collected data, including the Functional Independence Measure (FIM), Barthel Index, and Northwick Park Dependency Score and Care Needs Assessment (NPDS/NPCNA), which provides a generic estimation of dependency, care hours. and weekly cost of continuing care in the community. Patients were analysed in three groups according to dependency on admission: "low" (NPDS<10 (n=83)); "medium" (NPDS10-24 (n=112)); "high" (NPDS>24 (n=102)). Mean length of stay (LOS) 112 (SD 66) days. All groups showed significant reduction in dependency between admission and discharge on all measures (paired t tests: p<0.001). Mean reduction in "weekly cost of care" was greatest in the high dependency group at pound639 per week (95% CI 488 to 789)), as compared with the medium (pound323/week (95% CI 217 to 428)), and low (pound111/week (95% CI 42 to 179)) dependency groups. Despite their longer LOS, time t...Continue Reading

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Citations

Aug 2, 2007·The Journal of Head Trauma Rehabilitation·Kyaw NyeinLynne Turner-Stokes
Apr 15, 2006·Journal of Neurology, Neurosurgery, and Psychiatry·S Fleminger
Jul 1, 2011·Journal of Neurosciences in Rural Practice·Bhasker Amatya, Fary Khan
Mar 17, 2011·Clinical Medicine : Journal of the Royal College of Physicians of London·Rory J O'ConnorM Anne Chamberlain
Apr 13, 2010·Disability and Rehabilitation·William J Taylor, George Laking
Oct 9, 2007·Disability and Rehabilitation·Lynne Turner-Stokes
Apr 18, 2012·Disability and Rehabilitation·Lynne Turner-StokesDerar Badwan
Oct 4, 2013·Brain Injury : [BI]·Michael Oddy, Sara da Silva Ramos
Dec 20, 2008·Brain Injury : [BI]·Jennifer BeechamMartin Knapp
Jan 8, 2014·International Journal of Stroke : Official Journal of the International Stroke Society·Daniel K Y ChanGraeme J Hankey
Apr 3, 2016·Clinical Medicine : Journal of the Royal College of Physicians of London·Marie Therese Cooney, Áine Carroll
Sep 3, 2010·Annals of Physical and Rehabilitation Medicine·E BérardF Tasseau
Dec 17, 2014·Journal of Neurotrauma·Grace S GriesbachMark J Ashley
Jun 22, 2010·Clinical Rehabilitation·Lynne Turner-StokesDiana Jackson
Oct 16, 2015·Clinical Rehabilitation·Derick Wade
Nov 11, 2011·Clinical Rehabilitation·Lynne Turner-StokesKathy Eagar
Feb 25, 2009·Clinical Rehabilitation·William M M Levack
May 26, 2009·Multiple Sclerosis : Clinical and Laboratory Research·F KhanF Simmonds
Aug 25, 2017·Topics in Stroke Rehabilitation·Elizabeth A LynchSusan L Hillier
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Dec 24, 2015·The Cochrane Database of Systematic Reviews·Lynne Turner-StokesDerick T Wade
Jul 12, 2017·Case Reports in Neurological Medicine·Lauren SurdykePamela Spigel
Jan 4, 2021·International Urology and Nephrology·Ilan RozenbergKeren Cohen-Hagai
Nov 21, 2020·Journal of the American Medical Directors Association·Joshua K JohnsonMichael B Rothberg

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