Implementing a provincial case mix adjusted funding model for inpatient rehabilitation activity: the impact on bed designations

Abstract

Data In the fall of 2002, the Ontario Ministry of Health and Long Term Care (MOHLTC) mandated the collection of National Rehabilitation Reporting System (NRS) data in all designated adult inpatient rehabilitation beds. From these data we developed a case mix grouping methodology with associated weights. Together these are being used to incorporate adult inpatient rehabilitation activity into the Integrated Population Based Allocation (IPBA) hospital funding formula. In Ontario, designated inpatient rehabilitation is typically provided in two sectors. Within the acute care sector, hospitals may or may not have designated rehabilitation beds. Even in hospitals that do not have designated rehabilitation beds, a patient may receive some rehabilitation while an inpatient, or on an outpatient basis. For example, a patient who has just had surgery may be visited by a physiotherapist to increase rangeof-motion and strength while recovering from surgery. Within the rehabilitation hospital sector, facilities typically have designated rehabilitation beds and are usually referred to as rehabilitation hospitals. The care in these facilities is often organized on a programmatic basis, time limited and goal oriented. For example, a facility may have a stroke rehabilitation program that is 6 to 8 weeks long for individuals following stroke. These programs are provided on an inpatient basis and may or may not have an outpatient component at the end. Rehabilitation is also provided in other sectors of the health care system, but not on a designated inpatient basis. Provincial Implementation: