To describe differences in traumatic brain injury patient characteristics and outcomes
by inpatient rehabilitation facility profit status.
Retrospective database review utilizing the Uniform Data System for Medical Rehabilitation®
Inpatient rehabilitation facilities.
Individual discharges (n = 53,630) from 877 distinct rehabilitation facilities for
calendar years 2016 through 2018.
Main Outcome Measures
Patient demographic data (age, race, primary payer source), admission and discharge
Functional Independence Measure® (FIM®), FIM® gain, length of stay efficiency, acute
hospital readmission from for-profit and not-for-profit IRFs within 30 days, and community
discharges by facility profit status.
Patients at for-profit facilities were significantly older (69.69 vs. 64.12 years),
with lower admission FIM® scores (52 vs. 57), shorter lengths of stay (13 vs. 15 days),
and higher discharge FIM® scores (88 vs. 86); for-profit facilities had higher rates
of community discharges (76.8% vs. 74.6%), but also had higher rates of readmission
(10.3% vs. 9.9%).
The finding that for-profit facilities admit older patients who are reportedly less
functional on admission and more functional on discharge, with higher rates of community
discharge but higher readmission rates than not-for-profit facilities is an unexpected
and potentially anomalous finding. In general, older, less functional patients who
stay for shorter periods of time would not necessarily be expected to make greater
functional gains. These differences should be further studied, to determine if differences
in patient selection, coding/billing, or other unreported factors underlie these differences.