Comparison of Functional Independence Measure (FIM) Gain between Groups with Extreme Differences in FIM Score at Admission

Abstract

Objective: There are several methods for inter-hospital comparison of the improvement in Functional Independence Measure (FIM). However, it is not known which method is most suitable. The purpose of this study was to elucidate which of 4 methods can most successfully compare the average improvement in motor FIM (mFIM) at each hospital with the least influenced by the difference of mFIM score at admission. For this purpose, we considered 3 groups divided based on motor FIM score at admission as 3 hospitals. Methods: The subjects were 575 stroke patients hospitalized in a convalescent rehabilitation ward. We divided the subjects into 3 groups based on mFIM score at admission (13 to 38 points, 39 to 64 points, and 65 to 90 points) and investigated whether there were significant differences in the values derived from mFIM effectiveness, corrected mFIM effectiveness, deviation value of mFIM gain, and multiple regression analysis. Result: Significant difference in the improvement in mFIM between 3 groups divided by mFIM at admission was not observed only for the use of the deviation value of mFIM gain. Conclusion: Deviation value of mFIM gain, which is the least liable to the influence of differences in mFIM score at admission, is useful as a method to compare average improvement in mFIM among hospitals.