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Volume 88, Issue 11, Pages 1535-1541 (November 2007)


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Postacute Rehabilitation Research and Policy Recommendations

Dexanne B. Clohan, MDa, Elizabeth M. Durkin, PhDb, Joy Hammel, PhDc, Patrick Murray, MD, MSd, John Whyte, MD, PhDe, Marcel Dijkers, PhDf, Bruce M. Gans, MDgh, Daniel E. Graves, PhDi, Allen W. Heinemann, PhDjkCorresponding Author Informationemail address, Greg Worsowicz, MDlm

Abstract 

Clohan DB, Durkin EM, Hammel J, Murray P, Whyte J, Dijkers M, Gans BM, Graves DE, Heinemann AW, Worsowicz G. Postacute rehabilitation research and policy recommendations.

This article summarizes the research and health policy recommendations developed by participants at the symposium “State-of-the-Science on Post-Acute Rehabilitation: Setting a Research Agenda and Developing an Evidence Base for Practice and Public Policy,” held in February 2007. A diverse group of participants represented federal government agencies, private insurers, professional organizations, providers of rehabilitation services, patients and their advocates, and health researchers. During roundtable discussions and theme-specific break-out sessions, participants were asked to consider 5 major topics regarding postacute rehabilitation care: (1) the extent of our knowledge, (2) the limitations of our knowledge, (3) the barriers that limit research, (4) research priorities to reduce these obstacles and assemble needed evidence, and (5) the major policy implications. Several key themes emerged: the need for improved measures, particularly of case-mix factors and treatment ingredients; the need for a more uniform and coherent system of postacute rehabilitation care to facilitate gathering of common data; the need to attend to underutilization as well as overutilization of rehabilitation services; the need for cooperation among payers, providers, and researchers to advance a rehabilitation effectiveness research agenda; and the desire to develop payment policies that are based on research evidence.

a HealthSouth, Birmingham, AL

b Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL

c Departments of Occupational Therapy and Disability and Human Development, Doctoral Program in Disability Studies, University of Illinois, Chicago, IL

d Center for Healthcare Research and Policy, Department of Physical Medicine and Rehabilitation, MetroHealth, Cleveland, OH

e Moss Rehabilitation Research Institute and Rehabilitation Medicine, Thomas Jefferson University, Philadelphia, PA

f Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY

g Kessler Institute for Rehabilitation, West Orange, NJ

h Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, West Orange, NJ

i Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX

j Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL

k Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL

l Department of Physical Medicine and Rehabilitation, University of Missouri Columbia, School of Medicine, Columbia, MO

m Rusk Rehabilitation Center, Columbia, MO.

Corresponding Author InformationReprint requests to Allen W. Heinemann, PhD, Director, Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, 345 E Superior St, Chicago, IL 60611-2654

 Supported in part by the National Institute on Disability and Rehabilitation Research through the Rehabilitation Research and Training Center on Measuring Rehabilitation Outcomes and Effectiveness (grant no. H133B040032).

 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 authors or upon any organization with which the authors are associated.

PII: S0003-9993(07)01449-9

doi:10.1016/j.apmr.2007.07.022


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