Applying the clinical practice improvement approach to stroke rehabilitation: Methods used and baseline results

被引:91
作者
Gassaway, J
Horn, SD
DeJong, G
Smout, RJ
Clark, C
James, R
机构
[1] Int Sever Informat Syst Inc, Inst Clin Outcomes Res, Salt Lake City, UT 84102 USA
[2] Georgetown Univ, Natl Rehabil Hosp, Washington, DC USA
[3] Georgetown Univ, Dept Rehabil Med, Washington, DC USA
[4] Elmhurst Hosp Ctr, Ctr Clin Effectiveness, New York, NY USA
[5] Mt Sinai Sch Med, New York, NY 10029 USA
来源
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION | 2005年 / 86卷 / 12期
关键词
outcome assessment (health care); rehabilitation; severity of illness index; stroke;
D O I
10.1016/j.apmr.2005.08.114
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
Objectives: To describe the methods used and baseline data for the Post-Stroke Rehabilitation Outcomes Project (PSROP). Design: Prospective observational cohort study. Setting: Seven inpatient rehabilitation facilities (IRFs) in the United States and New Zealand. Participants: Consecutive convenience sample of 1291 poststroke rehabilitation patients, age older than 18, who were treated between 2001 and 2003 in 7 IRFs (1161 patients in 6 U.S. IRFs). Interventions: Not applicable. Main Outcome Measures: Change in FIM score, change in severity of illness, and discharge destination. Results: For the U.S. sample, the average age was 66 years, 52% were men, 60% were white, and 23% were black. Medicare was the most frequent payer. Seventy-seven percent of strokes were ischemic, with 43% in the left brain, 44% in the right brain, and 11% bilateral. Mean admission total FIM score was 61, with a mean motor FIM score of 40 and mean cognitive FIM score of 21. Lower FIM scores are associated with higher severity-of-illness scores. Mean rehabilitation length of stay was 18.6 days; 78% of patients were discharged home. At discharge, the average increase in total FIM score was 26, in motor FIM score was 22, and in cognitive FIM score was 4. Conclusions: This article outlines methods used in the PSROP, provides an overview of participating IRFs, describes the database, and summarizes key characteristics to enable readers of subsequent articles to better interpret study findings and determine generalizability.
引用
收藏
页码:S16 / S33
页数:18
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