Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 10 , Pages 1249-1255 , October 2007

Does the Presence of a Specialized Rehabilitation Unit in a Veterans Affairs Facility Impact Referral for Rehabilitative Care After a Lower-Extremity Amputation?

Presented as a poster to the American Physical Medicine and Rehabilitation. September 2007, Boston, MA.

  • Barbara E. Bates, MD

      Affiliations

    • Physical Medicine Service, VAMC Albany, NY
    • Physical Medicine and Rehabilitation, Albany Medical College, Albany, NY
    • Corresponding Author InformationCorrespondence to Barbara E. Bates, MD, Quality Management, VAMC Albany, 113 Holland Ave, Albany, NY 12208
  • ,
  • Jibby E. Kurichi, MPH

      Affiliations

    • Department of Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, PA
  • ,
  • Clifford R. Marshall, MS

      Affiliations

    • Physical Medicine and Rehabilitation Program Office, Department of Veterans Affairs Central Office, Gainesville, FL
  • ,
  • Dean Reker, PhD

      Affiliations

    • VAMC Kansas City, Kansas City, MO
    • Kansas University Medical Center, Kansas City, MO
  • ,
  • Greg Maislin, MS, MA

      Affiliations

    • Division of Sleep Medicine/Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA
  • ,
  • Margaret G. Stineman, MD

      Affiliations

    • Department of Physical Medicine and Rehabilitation, University of Pennsylvania, VA Center for Health Equity Research and Promotion, Philadelphia, PA.

References 

  1. Fletcher D, Andrews K, Hallett J, Butters M, Rowland C, Jacobsen S. Trends in rehabilitation after amputation for geriatric patients with vascular disease: implications for future health resource allocation. Arch Phys Med Rehabil. 2002;83:1389–1393
  2. Pezzin LE, Dillingham TR, MacKenzie EJ. Rehabilitation and the long-term outcomes of persons with trauma-related amputations. Arch Phys Med Rehabil. 2000;81:292–300
  3. Dillingham TR, Pezzin LE, MacKenzie EJ. Discharge destination after dysvascular lower-limb amputations. Arch Phys Med Rehabil. 2003;84:1662–1668
  4. Dillingham TR, Pezzin LE. Postacute care services use for dysvascular amputees. Am J Phys Med Rehabil. 2005;84:147–152
  5. Hoenig H, Duncan PW, Horner RD, et al. Structure, process, and outcomes in stroke rehabilitation. Med Care. 2002;40:1036–1047
  6. Hoenig H, Horner RD, Duncan PW, Clipp E, Hamilton B. New horizons in stroke rehabilitation research. J Rehabil Res Dev. 1999;36:19–31
  7. Mayfield JA, Reiber GE, Maynard C, Czerniecki JM, Caps MT, Sangeorzan BJ. Survival following lower-limb amputation in a veteran population. J Rehabil Res Dev. 2001;38:341–345
  8. Dillingham T, Pezzin L, MacKenzie E. Limb amputation and limb deficiency: epidemiology and recent trends in the United States. South Med J. 2002;95:875–883
  9. Mayfield JA, Reiber GE, Maynard C, Czerniecki JM, Caps MT, Sangeorzan BJ. Trends in lower limb amputation in the Veterans Health Administration, 1989-1998. J Rehabil Res Dev. 2000;37:23–37
  10. Collins TC, Beyth RJ. Process of care and outcomes in peripheral arterial disease. Am J Med Sci. 2003;325:125–134
  11. Dillingham TR, Pezzin LE, MacKenzie EJ. Incidence, acute care length of stay, and discharge to rehabilitation of traumatic amputee patients: an epidemiologic study. Arch Phys Med Rehabil. 1998;79:279–297
  12. Bates B, Stineman MG, Reker D, Kurichi J, Kwong PL. Risk factors associated with mortality following trans-tibial or trans-femoral amputation. J Rehabil Res Dev. 2007;43:917–928
  13. Elixhauser A, Steiner C, Harris DR, Coffey RM. Comorbidity measures for use with administrative data. Med Care. 1998;36:8–27
  14. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–383
  15. Southern DA, Quan H, Ghali WA. Comparison of the Elixhauser and Charlson/Deyo methods of comorbidity measurement in administrative data. Med Care. 2000;42:355–360
  16. Stukenborg GJ, Wagner DP, Connors AF. Comparison of the performance of two comorbidity measures, with and without information from prior hospitalizations. Med Care. 2001;39:727–739
  17. Deyo R, Cherkin D, Ciol M. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992;45:613–619
  18. Hanley JA, McNeil BJ. The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology. 1982;143:29–36
  19. Hosmer DL. Applied logistic regression. New York: John Wiley & Sons; 1989;
  20. Statistical Analysis Software [computer program]. Cary: SAS; 2003;Version 9.1
  21. VHA Office of Quality Improvement. Available at: http://www.oqp.med.va.gov. Accessed January 11, 2007.
  22. Kane RL, Lin WC, Blewett LA. Geographic variation in the use of post-acute care. Health Serv Res. 2002;37:667–682
  23. Buntin MB, Gartin AD, Paddock S, Saliba D, Totten M, Escarce JJ. How much is postacute care use affected by its availability?. Health Serv Res. 2005;40:413–434
  24. Moran Company. Utilization trends in inpatient rehabilitation: update through QII 2006. Arlington: Moran Co; 2006;Sept
  25. Agency for Healthcare Research and Quality. HCUP Nationwide Inpatient Sample. Available at: http://www.hcup-us.ahrq.gov/toolssoftware/comorbidity/comorbidity.jsp#variables. Accessed January 11, 2007.
  26. Hoenig H, Sloane R, Horner RD, Zolkewitz M, Reker D. Differences in rehabilitation services and outcomes among stroke patients cared for in Veterans hospitals. Health Serv Res. 2001;35:1293–1318
  27. Hoenig H, Sloane R, Horner RD, Zolkewitz M, Duncan PW, Hamilton BB. A taxonomy for classification of stroke rehabilitation services. Arch Phys Med Rehabil. 2000;81:853–862

 Supported in part by the National Institutes of Health (grant no. Ro1 HD042588), the Samuel S. Stratton Department of Veterans Affairs Medical Center, Albany, NY, and the Kansas City Department of Veterans Affairs Medical Center, Kansas City, MO.

 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)00439-X

doi: 10.1016/j.apmr.2007.06.018

Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 10 , Pages 1249-1255 , October 2007