Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 7 , Pages 827-832 , July 2007

The Effect of the Introduction of a Case-Mix−Based Funding Model of Rehabilitation for Severe Stroke: An Australian Experience

Presented to the Joint Conference of the National Neurology and Gerontology Groups of the Australian Physiotherapy Association, November 17, 2005, Melbourne, Australia, and the 14th Annual Scientific Meeting of the Australasian Faculty of Rehabilitation Medicine, May 4, 2006, Cairns, Australia.

  • Kim A. Brock, PhD

      Affiliations

    • Physiotherapy Department, St. Vincent’s Health, Melbourne, Victoria Pde, Fitzroy, Australia
    • Corresponding Author InformationCorrespondence to Kim A. Brock, PhD, Physiotherapy Dept, St. Vincent’s Health, Melbourne, Victoria Pde, Fitzroy, 3065, Australia
    • ,
  • Stephen J. Vale, MPhysio, MBus

      Affiliations

    • Allied Health and Community Programs, St. Vincent’s Health, Melbourne, Australia
    • ,
  • Susan M. Cotton, PhD

      Affiliations

    • ORYGEN Youth Health, Department of Psychiatry, University of Melbourne, Carlton, Australia.

References 

  1. Department of Health, Housing, Local Government and Community Service. Casemix: a new direction in health care management (The National Casemix Education Series, Part A). Canberra: Australian Institute for Health and Welfare; 1993;
  2. Duckett S, Gray L, Howe A. Designing a funding system for rehabilitation services (Part 1: Rationale and recent developments). Aust Health Rev. 1995;18:30–44
  3. Duckett S, Gray L, Howe A. Designing a funding system for rehabilitation services (Part 2: Policy objectives and options for achieving efficiency and quality of care). Aust Health Rev. 1995;18:62–77
  4. Gagnon D, Nadeau S, Tam V. Clinical and administrative outcomes during publicly-funded inpatient stroke rehabilitation based on a casemix group classification model. J Rehabil Med. 2005;37:45–52
  5. Han L, Law-Gibson E, Reding M. Key neurological impairments influence function-related group outcomes after stroke. Stroke. 2002;33:1920–1924
  6. Granger CV, Albrecht GL, Hamilton BB. Outcomes of comprehensive medical rehabilitation: measurement by PULSES Profile and the Barthel Index. Arch Phys Med Rehabil. 1979;60:145–154
  7. Uniform Data System for Medical Rehabilitation. Guide for use of the Uniform Data Set for Medical Rehabilitation including the Functional Independence Measure. Buffalo: Research Foundation, State University of New York; 1995;Version 4
  8. Stineman MG, Escarce JJ, Goin JE, Hamilton BB, Granger CV, Williams SV. A case-mix classification system for medical rehabilitation. Med Care. 1994;32:366–379
  9. Eager K, Gordon R, Hodkinson A, et al. The Australian National Sub-Acute and Non-Acute Patient Classification (AN-SNAP): report of the National Subacute and Nonacute Casemix Classification Study. Wollongong: Centre for Health Service Development, University of Wollongong; 1997;
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  11. Granger CV, Cotter AC, Hamilton BB, Fiedler RC. Functional Assessment Scales: a study of persons after stroke. Arch Phys Med Rehabil. 1993;74:133–138
  12. Heinemann AW, Linacre JM, Wright BD, Hamilton BB, Granger CV. Prediction of rehabilitation outcomes with disability measures. Arch Phys Med Rehabil. 1994;75:133–143
  13. Linacre JM, Heinemann AW, Wright BD, Granger CV, Hamilton BB. The structure and stability of the Functional Independence Measure. Arch Phys Med Rehabil. 1994;75:127–132
  14. Stineman MG, Shea JA, Jette A, et al. The Functional Independence Measure: tests of scaling assumptions, structure, and reliability across 20 diverse impairment categories. Arch Phys Med Rehabil. 1996;77:1101–1108
  15. Granger CV, Ottenbacher KJ, Fiedler RC. The Uniform Data System for Medical Rehabilitation: report of first admissions for 1993. Am J Phys Med Rehabil. 1995;74:62–66
  16. Fiedler RC. The Rasch measurement model. UDS Update. 1993;7:1–10
  17. Stineman MG, Fiedler RC, Granger CV, Maislin G. Functional task benchmarks for stroke rehabilitation. Arch Phys Med Rehabil. 1998;79:497–504
  18. Jorgensen HS, Nakayama H, Raaschou HO, Vive-Larsen J, Stoier M, Olsen TS. Outcome and time course of recovery in stroke (Part 1: Outcome. The Copenhagen study). Arch Phys Med Rehabil. 1995;76:399–405
  19. Bode R, Heinemann A. Course of functional improvement after stroke, spinal cord injury, and brain trauma. Arch Phys Med Rehabil. 2002;83:100–106
  20. Lowthian P, Disler P, Ma S. The Australian National Sub-acute and Non-acute Patient Casemix Classification (AN-SNAP): its application and value in a stroke rehabilitation programme. Clin Rehabil. 2000;14:532–537
  21. Jorgensen H, Nakayama H, Raaschou H, Olsen T. Acute stroke care and rehabilitation: an analysis of the direct cost and its clinical and social determinants. Stroke. 1997;28:1138–1141
  22. Stineman M. Prospective payment, prospective challenge. Arch Phys Med Rehabil. 2002;83:1802–1805
  23. Saitto C, De Bernardini L, Di Benedetto P, et al. A new system for the prospective payment of inpatient rehabilitation: a summary of the research project: “Development of an iso-resource classification for the prospective payment of rehabilitation care.”. Eur Medicophysica. 2003;39:205–209

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.Reprints are not available from the author.

PII: S0003-9993(07)00289-4

doi: 10.1016/j.apmr.2007.04.001

Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 7 , Pages 827-832 , July 2007

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