Inpatient Rehabilitation Outcomes for Older Adults with Nondebility Generalized Weakness

Abstract

This study aimed to compare the functional outcomes and discharge locations of older adults admitted to inpatient rehabilitation with debility (International Classification of Diseases, 9th Revision, Clinical Modification, [ICD-9-CM] code 799.3) with those of patients with a nondebility generalized weakness diagnosis (ICD-9-CM codes 728.2, 728.87, and 780.79). This is a retrospective cohort study using 2002-2003 information from the Uniform Data System for Medical Rehabilitation. Patients were 65 yrs or older admitted to inpatient rehabilitation with a primary diagnosis of debility (n = 14,835) and nondebility generalized weakness (n = 6,403). Primary outcome measures were change in functional status, including efficiency (functional status change divided by length of stay in days), and discharge setting. The efficiency of the patients with nondebility generalized weakness (1.8 ± 1.9) was statistically greater than that of patients with debility (1.7 ± 2.1, P = 0.002), and significantly more patients with nondebility generalized weakness were discharged home (70% vs. 68%, P = 0.003). From a clinical standpoint, the functional recovery and rate of discharge to home of inpatient rehabilitation patients with nondebility generalized weakness are nearly identical to those of patients with debility. Although it would require a policy change, we recommend using a single diagnostic code for all of these patients to further research in this area of rehabilitation.