Abstract
Objective
To examine the association between the Medicare pressure ulcer quality indicator (the
development of new or worsened pressure ulcers) and rehabilitation outcomes among
Medicare patients seen in an inpatient rehabilitation facility (IRF).
Design
Retrospective descriptive study.
Setting
IRFs subscribed to the Uniform Data System for Medical Rehabilitation.
Participants
Nearly 500,000 IRF Medicare patients who were discharged between January 2013 and
September 2014 were examined.
Interventions
Not applicable.
Main Outcome Measures
Functional independence, functional change (gain), and discharge destination.
Results
The pressure ulcer quality indicator was associated with poorer rehabilitation outcomes;
patients were less likely to achieve functional independence (odds ratio [OR], .47;
95% confidence interval [CI], .44–.51), were less likely to be discharged to a community
setting (OR, .88; 95% CI, .82–.95), and made less functional gain during their IRF
stay (a difference of 6 FIM points).
Conclusions
These results support that the pressure ulcer quality indicator is associated with
lower quality of rehabilitation outcomes; however, given that those patients with
a new or worsened pressure injury still made functional gains and most were discharged
to the community, the risk of pressure injury development should not preclude the
admission of these cases to an IRF.
Keywords
List of abbreviations:
CI (confidence interval), CMS (Centers for Medicare and Medicaid Services), IRF (inpatient rehabilitation facility), IRF-PAI (Inpatient Rehabilitation Facility Patient Assessment Instrument), NQF (National Quality Forum), UDSMR (Uniform Data System for Medical Rehabilitation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 09, 2018
Footnotes
Supported in part by a faculty development grant from the SUNY Cortland.
Disclosures: None.
Identification
Copyright
Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
