Study: Inpatient Rehabilitation Hospital Patients Have Better Outcomes, Live Longer

Release date

Friday, July 18th 2014

(July 2, 2014) -- A new study released this month at a Congressional briefing hosted by Sens. Tim Johnson (D-S.D.) and Mark Kirk (R-Ill.) shows that brain injury and stroke patients treated in inpatient rehabilitation hospitals and units had better long-term clinical outcomes than those treated in nursing homes. The study is the most comprehensive national analysis to date examining the long-term outcomes of clinically similar patient populations treated in inpatient rehabilitation hospitals/units or nursing homes.

“This study shows that patients treated in inpatient rehabilitation hospitals and units have better outcomes, go home earlier and live longer than those treated in skilled nursing facilities,” said Karl Sandin, President and Chief Medical Officer of Schwab Rehabilitation Hospital, a member organization of the Chicago-based safety net health system, Sinai Health System. “Rehabilitation hospitals and units are key to reducing costly hospital readmissions for those with a wide range of disabling conditions.”

Key Findings

Assessment of Patient Outcomes of Rehabilitative Care Provided in Inpatient Rehabilitation Facilities and After Discharge conducted by Dobson DaVanzo & Associates, LLC, studied a national sample of Medicare fee-for-service claims data to compare the clinical outcomes and Medicare payments for patients who received rehabilitation in an inpatient rehabilitation hospital to clinically similar patients in nursing homes. The study’s key findings show: • Over a two-year study period, inpatient rehabilitation hospital and unit patients clinically comparable to skilled nursing facility patients, on average: o Returned home from their initial hospital rehabilitation stay two weeks earlier o Remained home nearly two months longer o Stayed alive nearly two months longer • Of matched patients treated: o Inpatient rehabilitation hospital and unit patients showed an 8 percent lower mortality rate than skilled nursing facility patients. o Inpatient rehabilitation hospital and unit patients with 5 of the 13 diagnostic conditions – amputation, brain injury, hip fracture, major medical complexity and pain syndrome – showed significantly fewer hospital readmissions than skilled nursing facility patients. o Inpatient rehabilitation hospital and unit patients made 5 percent fewer emergency room visits per year than skilled nursing facility patients.

To see the full study and an infographic highlighting key study points, visit https://www.amrpa.org/Public/Study_Rehab_Hospitals_Yield_Better_Outcomes...

The Role of Inpatient Rehabilitation Hospitals and Units

Inpatient rehabilitation hospitals and units are an integral part of the nation’s health care system. They play a crucial role in advancing the care, treatment and recovery of individuals with disabling injuries and illnesses.

Rehabilitation hospitals offer a unique level of care – a highly specialized, medically supervised and carefully coordinated program that improves a patient’s health, function, mobility and independence. This includes restoring the skills and abilities to perform daily tasks, such as bathing, dressing and eating. Rehabilitation hospitals and units prepare patients to successfully return to home, work school and community activities. Typical conditions treated in these medical rehabilitation hospitals include stroke, brain and spinal cord injury, neurological diseases and major musculoskeletal disorders.

Schwab Rehabilitation Hospital is a freestanding, not-for-profit rehabilitation hospital that offers a therapeutic environment for comprehensive inpatient and outpatient rehabilitation services, for adults and children. Schwab’s intensive inpatient rehabilitation program schedules each patient for a minimum of three hours of therapy, five or more days a week. Schwab also has a rehabilitation focused, short-term, subacute unit. Schwab has seven treatment gyms featuring state-of-the-art equipment, private treatment rooms, a warm-water indoor therapy pool and an award-winning therapeutic rooftop garden.

Schwab was the first fully licensed and accredited rehabilitation hospital in the Midwest. Schwab maintains accreditation with both The Joint Commission and Commission on Accreditation of Rehabilitation Facilities (CARF).

About the Study

The ARA Research Institute, an affiliate of the American Medical Rehabilitation Providers Association, commissioned Dobson DaVanzo & Associates, LLC, to conduct a retrospective study of inpatient rehabilitation hospital and unit patients and clinically similar nursing home patients to examine the downstream comparative utilization, effectiveness of post-acute care pathways, and total cost of treatment during the five years following the implementation of the 60 percent rule.

Using a 20 percent sample of Medicare beneficiary claims, this study analyzed all Medicare Parts A and B claims across all care settings (excluding physicians and durable medical equipment) from 2005 through 2009. Using statistical matching methods, 100,000 clinically similar pairs of patients were identified. Two-year care episodes were created to track all health care utilization and payments following discharge from an index acute care hospitalization that resulted in a transfer to either an inpatient rehabilitation hospital or unit, or a nursing home. This episode length allowed the capture of the long-term impact of the rehabilitation, including meaningful differences in mortality, use of downstream facility-based care, and patients’ ability to remain home.

Study Limitation: Medicare fee-for-service claims do not include care covered and reimbursed by Medicaid and third parties. Therefore, non-Medicare services, such as long-term nursing home stays, are not captured in this analysis. This omission may overestimate the calculated number of days a patient remains at home, and underestimate the cost of their health care to the federal and state governments.

About Sinai Health System

Sinai Health System, a Chicago-based private, not-for-profit organization, is comprised of seven member organizations: Mount Sinai Hospital, Holy Cross Hospital, Sinai Children’s Hospital, Schwab Rehabilitation Hospital, Sinai Medical Group, Sinai Community Institute and Sinai Urban Health Institute. The system has over 800 physicians on its hospital medical staffs, 695 licensed beds, 100,000+ annual emergency department patient visits and eight physician residency training programs. www.sinai.org