Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 8 , Pages 1269-1283 , August 2009

Characterizing Rehabilitation Services for Patients With Knee and Hip Replacement in Skilled Nursing Facilities and Inpatient Rehabilitation Facilities

Presented to the American Congress of Rehabilitation Medicine, October 4, 2007, Washington, DC.

  • Gerben DeJong, PhD

      Affiliations

    • Center for Post-acute Studies, National Rehabilitation Hospital, Washington, DC
    • Corresponding Author InformationReprint requests to Gerben DeJong, PhD, Center for Post-acute Studies, National Rehabilitation Hospital, 102 Irving St, Washington, DC 20010
  • ,
  • Ching-Hui Hsieh, PhD

      Affiliations

    • Center for Post-acute Studies, National Rehabilitation Hospital, Washington, DC
  • ,
  • Julie Gassaway, MS, RN

      Affiliations

    • Institute for Clinical Outcomes and Research, Salt Lake City, UT
  • ,
  • Susan D. Horn, PhD

      Affiliations

    • Institute for Clinical Outcomes and Research, Salt Lake City, UT
  • ,
  • Randall J. Smout, MS

      Affiliations

    • Institute for Clinical Outcomes and Research, Salt Lake City, UT
  • ,
  • Koen Putman, PT, PhD

      Affiliations

    • Center for Post-acute Studies, National Rehabilitation Hospital, Washington, DC
    • Department of Medical Sociology and Health Sciences, Vrije Universiteit Brussel, Belgium
  • ,
  • Roberta James, MStat

      Affiliations

    • Institute for Clinical Outcomes and Research, Salt Lake City, UT
  • ,
  • Michael Brown, BA

      Affiliations

    • Center for Post-acute Studies, National Rehabilitation Hospital, Washington, DC
  • ,
  • Elizabeth M. Newman, OTD, OTR/L

      Affiliations

    • National Rehabilitation Hospital, Washington, DC
  • ,
  • Mary P. Foley, BS, CRRN

      Affiliations

    • National Rehabilitation Hospital, Washington, DC

References 

  1. Tian W, DeJong G, Brown M, Hsieh J, Zamfirov Z. Looking upstream: factors shaping the demand for postacute joint replacement rehabilitation. Arch Phys Med Rehabil. 2009;90:1260–1268
  2. MedPAC. Chapter 5: payment for post-acute care (Report to Congress: issues in a Modernized Medicare Program). In: Washington (DC): MedPAC; 2005;p. 105–133
  3. DeJong G, Horn SD, Smout RJ, Tian W, Putman K. Joint replacement rehabilitation outcomes on discharge from skilled nursing facilities and inpatient rehabilitation facilities. Arch Phys Med Rehabil. 2009;90:1284–1296
  4. Bulthuis Y, Drossaers-Bakker KW, Taal E, et al. Arthritis patients show long-term benefits from 3 weeks intensive exercise training directly following hospital discharge. Rheumatology. 2007;46:1712–1717
  5. Giaquinto A, Ciotola E, Margutti F. Gait during hydrokinesitherapy following total knee arthroplasty. Disabil Rehabil. 2007;29:737–742
  6. Lenssen A, Crijns YH, Waltje EM, et al. Efficiency of immediate postoperative inpatient physical therapy following total knee arthroplasty: an RCT. BMC Musculoskelet Disord. 2006;7:1–9
  7. Minns Lowe C, Barker KL, Dewey M, Sackley CM. Effectiveness of physiotherapy exercise after knee arthroplasty for osteoarthritis: systematic review and meta-analysis of randomized controlled trials. Br Med J. 2007;335:812–820
  8. Roos E. Effectiveness and practice variation of rehabilitation after joint replacement. Curr Opin Rheumatol. 2003;15:160–162
  9. Unlu E, Eksioglu E, Aydog E, Aydog ST, Atay G. The effect of exercise on hip muscle strength, gait speed and cadence in patients with total hip arthroplasty: a randomized controlled study. Clin Rehabil. 2007;21:706–711
  10. Frost K, Bertocci GE, Wassinger CA, Munin MC, Burdett RG, Fitzgerald SG. Isometric performance following total hip arthroplasty and rehabilitation. J Rehabil Res Dev. 2006;43:435–444
  11. Lang C. Comparison of 6- and 7-day physical therapy coverage on length of stay and discharge outcome for individuals with total hip and knee arthroplasty. J Orthop Sports Phys Ther. 1998;28:15–22
  12. Munin M, Rudy TE, Glynn NW, Crossett LS, Rubash HE. Early inpatient rehabilitation after elective hip and knee arthroplasty. JAMA. 1998;279:847–852
  13. Keith R. Treatment strength in rehabilitation. Arch Phys Med Rehabil. 1997;78:1298–1304
  14. U.S. Census Bureau. Census regions and divisions of the United States. http://www.census.gov/geo/www/us_regdiv.pdfAccessed February 16, 2009
  15. Buckle J, Horn SD, Oates VM, Abbey H. Severity of illness and resource use differences among white and black hospitalized elderly. Arch Intern Med. 1992;152:1596–1603
  16. Stoskopf C, Horn SD. The computerized psychiatric severity index as a predictor of inpatient length of stay for psychoses. Med Care. 1991;29:179–195
  17. Averill R, McGuire TE, Manning BE, et al. A study of the relationship between severity of illness and hospital cost in New Jersey hospitals. Health Serv Res. 1992;27:587–617
  18. Clemmer T, Spuhler VJ, Oniki TA, Horn SD. Results of a collaborative quality improvement program on outcomes and costs in a tertiary critical care unit. Crit Care Med. 1999;27:1768–1774
  19. Horn S, Sharkey PD, Buckle JM, Backofen JE, Averill RF, Horn RA. The relationship between severity of illness and hospital length of stay and mortality. Med Care. 1991;29:305–317
  20. Horn SD, Torres A, Willson D, Dean JM, Gassaway J, Smout RJ. Development of a pediatric age- and disease-specific severity measure. J Pediatr. 2002;141:496–503
  21. Ryser D, Egger MJ, Horn SD, Handrahan D, Grandhi P, Bigler ED. Measuring medical complexity during inpatient rehabilitation following traumatic brain injury. Arch Phys Med Rehabil. 2005;86:1108–1117
  22. Willson D, Horn SD, Smout RJ, Gassway J, Torres A. Severity assessment in children hospitalized with bronchiolitis using the pediatric component of the Comprehensive Severity Index (CSI). Pediatr Crit Care Med. 2000;1:127–132
  23. Buchanan J, Andres PL, Haley SM, Paddock SM, Zaslavsky AM. An assessment tool translation study. Health Care Financ Rev. 2003;24:45–60
  24. Buchanan J, Andres PL, Haley SM, Paddock SM, Zaslavsky AM. Evaluating the planned substitution of the minimum data set—post acute care for use in the rehabilitation hospital prospective payment system. Med Care. 2004;42:155–163
  25. Jette A, Haley SM, Ni P. Comparison of functional status tools used in post-acute care. Health Care Financ Rev. 2003;24:13–24
  26. Medicare Payment Advisory Commission. Report to the Congress: Medicare payment policy. Washington (DC): MedPAC; 2008;
  27. Gage B, Morley M, Constantine R, et al. Examining relationships in an integrated hospital system. Boston: RTI International; 2008;
  28. Center for Post-acute Studies. CPS analysis. Washington (DC): Center for Post-acute Studies, National Rehabilitation Hospital; 2008;
  29. Escobar A, Quintana JM, Bilbao A, et al. Effect of patient characteristics on reported outcomes after total knee replacement. Rheumatology. 2007;46:112–119
  30. Kennedy D, Stratford PW, Hanna SE, Wessel J, Gollish JD. Modeling early recovery of physical function following hip and knee arthroplasty. BMC Musculoskelet Disord. 2006;7:100–114
  31. Lingard E, Katz JN, Wright EA, Sledge CB Kinemax Outcomes Group. Predicting the outcome of total knee arthroplasty. J Bone Joint Surg Am. 2004;86-A:2179–2186
  32. Vincent K, Vincent HK, Lee LW, Alfano AP. Inpatient rehabilitation outcomes in primary and revision total knee arthroplasty patients. Clin Orthop Relat Res. 2006;201–207(May)
  33. Walker W, Keyser-Marcus LA, Cifu DX, Chaudhri M. inpatient interdisciplinary rehabilitation after total hip arthroplasty surgery: a comparison of revision and primary total hip arthroplasty. Arch Phys Med Rehabil. 2001;82:129–133
  34. Walsh M, Herbold J. Outcome after rehabilitation for total joint replacement at IRF and SNF: a case-controlled comparison. Am J Phys Med Rehabil. 2006;85:1–5
  35. Beeuwkes Buntin M, Partha D, Escarce J, Hoverman C, Paddock S, Sood N. Comparison of Medicare spending and outcomes for beneficiaries with lower extremity joint replacements (RAND Health Working Paper Series). http://works.bepress.com/melinda_buntin/7Accessed July 8, 2009
  36. White K, Begun J, Tian W. Hospital service offerings: does Catholic ownership matter?. Health Care Manag Rev. 2006;31:99–108

 Supported by the HealthSouth Corp, ARA Research Institute of the American Rehabilitation Providers Association, Brooks Health, National Rehabilitation Hospital, American Hospital Association, the Federation of American Hospitals, and others.

 A commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a financial benefit on the author or one or more of the authors.

PII: S0003-9993(09)00302-5

doi: 10.1016/j.apmr.2008.11.021

Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 8 , Pages 1269-1283 , August 2009