Abstract
ObjectivesTo test the validity and reliability of a tool specifically developed for the evaluation of appropriateness in rehabilitation facilities and to assess the prevalence of appropriateness of the days of stay.MethodsThe tool underwent a process of cross-cultural translation, content validity, and test-retest validity. Two hospital-based rehabilitation wards providing intensive rehabilitation care located in the Region of Calabria, Southern Italy, were randomly selected. A review of medical records on a random sample of patients aged 18 or more was performed.ResultsThe process of validation resulted in modifying some of the criteria used for the evaluation of appropriateness. Test-retest reliability showed that the agreement and the k statistic for the assessment of the appropriateness of days of stay were 93.4% and 0.82, respectively. A total of 371 patient days was reviewed, and 22.9% of the days of stay in the sample were judged to be inappropriate. The most frequently selected appropriateness criterion was the evaluation of patients by rehabilitation professionals for at least 3 hours on the index day (40.8%); moreover, the most frequent primary reason accounting for the inappropriate days of stay was social and/or family environment issues (34.1%).ConclusionsThe findings showed that the tool used is reliable and have adequate validity to measure the extent of appropriateness of days of stay in rehabilitation facilities and that the prevalence of inappropriateness is contained in the investigated settings. Further research is needed to expand appropriateness evaluation to other rehabilitation settings, and to investigate more thoroughly internal and external causes of inappropriate use of rehabilitation services.
Highlights
In recent years, developed countries have faced a growing demand for rehabilitation services, attributable to the ageing population and the increasing prevalence of disability due to technical advances in acute healthcare.The changed healthcare needs of the population and the growing costs related to rehabilitation services utilization have stimulated a growing interest in research aimed at the investigation of effectiveness of post-acute care [1,2,3] and appropriateness [4,5,6,7] of these services.It should be pointed out, that there is substantial heterogeneity in rehabilitation interventions according to diagnoses and types of patients
The following data were recorded for each patient: sociodemographic characteristics, information related to hospitalization, and the evaluation of patient’s autonomy in performing the basic activities of daily living (BADL) at admission
Palliative care and vital sign monitoring were considered to be best suitable in facilities that are classified as high-specialty intensive rehabilitation
Summary
The changed healthcare needs of the population and the growing costs related to rehabilitation services utilization have stimulated a growing interest in research aimed at the investigation of effectiveness of post-acute care [1,2,3] and appropriateness [4,5,6,7] of these services It should be pointed out, that there is substantial heterogeneity in rehabilitation interventions according to diagnoses and types of patients. Depending on the type of care provided, post-acute rehabilitation is set up at three different levels of care: the intensive rehabilitation (three or more hours a day of therapy), the high-specialty intensive rehabilitation (e.g., spinal unit), and the extensive rehabilitation (at least one hour but less than three hours a day of therapy) It can be delivered in a variety of healthcare settings, ranging from dedicated wards in hospitals providing acute care to long-term care facilities. Each of these facilities can provide one or more levels of rehabilitation, and the aim is to provide rehabilitation care that best suites patient needs in the most appropriate setting
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
