The influence of age on length of stay, functional independence and discharge destination of rehabilitation inpatients in Italy

Advanced age in itself does not predict a poor functional outcome or a longer length of stay in rehabilitation units. Seven hundred and sixty-four adult cases were analysed, from 14 post-acute rehabilitation facilities throughout Italy. Data came from the national database run by the agency distributing the Italian version of an internationally validated scale of disability, the FIM (C) (sm) (Functional Independence Measure). The FIM is an 18-item scale rating independence in the domains of self-care, sphincter control, mobility, locomotion, communication and social cognition. The total FIM score may range from 18 to 126 (higher score = greater independence). Patients were classified with respect to the cut-off age of 75 years (76+ and 75-, mean age 82 and 57 years, n = 203 and 561, 27 % and 73 % of the cases, respectively). The median interval between onset of disability and admission to the facility (onset-to-admission delay, OAD) was 36 and 45 days in the 76+ and the 75- group, respectively (p < 0001). Mean admission FIM score was 70 (+/-28) in the 76 + and 71 (+/-27) in the 75- group. Discharge FIM scores were 84+/-29 and 93+/-26, respectively (p < 0001). Median length of stay (LOS) was 34 days in the 76+ and 41 days in the 75- group, respectively (p < 0005). The 76+ and 75- groups were discharged home in 86 % and 90 % of the cases, respectively (p = 0.053). The results suggest that inpatient rehabilitation is substantially effective and efficient for older as well as for younger patients.