Poster 50: Outcomes of Inpatient Rehabilitation for Deconditioning

Abstract

Objectives: To collect information on the outcomes of older adults who have received inpatient rehabilitation for deconditioning and to investigate whether the diagnosis of deconditioning (ICD-9 code 799.3) might be included as a criterion medical condition for classification as an inpatient rehabilitation facility under the Center for Medicare and Medicaid Services 75% rule. Design: Retrospective cohort study of patients included in the Uniform Data System for Medical Rehabilitation (UDSmr) database for 2002 to 2003. Setting: Inpatient rehabilitation facilities in the United States subscribing to UDSmr. Participants: 63,171 individuals ≥65 years old (62% women, 98% previously living independently) with a primary (23%) or secondary (77%) diagnosis of deconditioning. Interventions: Not applicable. Main Outcome Measures: FIM efficiency (change in FIM score/length of stay [in days]), FIM efficiency subscores for locomotion and self-care, and discharge settings. Results: Individuals with a primary diagnosis of deconditioning (PDD) had a significantly lower FIM efficiency compared with the remaining subjects (1.78 vs 1.90, P<.001), or to the subgroup of subjects with a 75% rule primary diagnosis (1.67 vs 1.88, P<.001). The individuals with PDD also had lower FIM efficiency subscores, were less likely to be discharged to the community (73% vs 76%, P<.001) or home (68% vs 73%, P<.001), and were more likely to be discharged to a hospital (7% vs 4%, P<.001). Conclusions: Older individuals with PDD appear to recover at a slower rate than those with a secondary diagnosis of deconditioning, and are somewhat less likely to return home. The clinical significance of these findings is uncertain, but further investigation is warranted.