Changes in reimbursement climate: Relationship among outcome, cost, and payor type in the postacute rehabilitation environment

Ashley, Mark J.; Persel, Craig S.; Krych, David

doi:10.1097/00001199-199312000-00005

Cited by 18 publications

(4 citation statements)

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“…With shorter acute stays, persons entering post-acute programmes typically have more significant medical, cognitive, physical and behaviour complications than were seen a decade ago. At the same time, insurance and public payers have become more discriminating in providing financial support for persons with brain injuries entering post-acute rehabilitation programmes [3]. These issues point to the importance of measuring both the effectiveness of post-acute rehabilitation and the 'value' or return on investment for all consumers to help guide future decisionmaking on access to care [4].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of post-acute rehabilitation for persons with brain injury

et al. 2010

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Section: Introductionmentioning

confidence: 99%

Outcomes of post-acute rehabilitation for persons with brain injury

et al. 2010

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“…Individual items responses are entered into a computer and are scored by a software program according to instructions for each outcome scale. These outcome scales included the DRS, 18 MayoPortland Adaptability Inventory-4 (MPAI-4), 19 Community Integration Questionnaire (CIQ), 20 Centre for Neuro Skills Scale (CNS), 21 Occupational Status Scale (OSS), 21 and the Living Status Scale (LSS). 21 These scales are used to evaluate level of disability and social, cognitive, emotional, and physical problems during the post-acute period after brain injury.…”

Section: Rehabilitation Effectivenessmentioning

confidence: 99%

Post-Acute Traumatic Brain Injury Rehabilitation: Effects on Outcome Measures and Life Care Costs

Griesbach

Kreber²,

Harrington³

et al. 2015

Journal of Neurotrauma

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Rehabilitation is the predominant post-acute treatment for patients with traumatic brain injury (TBI). We retrospectively evaluated the effectiveness of post-acute TBI rehabilitation by comparing outcome measures and life care cost with that of patients with cerebrovascular accident (CVA) who underwent a multidisciplinary rehabilitation program within the same facility. To better assess the effects of rehabilitation, we only included patients with no benefit limitations from the insurance carrier. Functional effectiveness was determined by comparing outcome scales, which included the Disability Rating Scale, Mayo Portland Inventory, Occupational Status Scale, Living Status Scale, and the Centre for Neuro Skills Scale. Cost-effectiveness was determined by having certified life care planners create separate cost projections from the admission and discharge patient files. This allowed us to compare cost projections with and without rehabilitation for each patient. Significant decreases in the cost projections, i.e., rehabilitation savings (RS), were found after rehabilitation for TBI. These RS were equivalent to those of patients with CVA. Likewise, equivalent improvements were found on all of the outcome scales for both brain injury groups. We also evaluated if the latency from TBI to admission in the rehabilitation program had an influence on outcome. Cost and functional effectiveness was more marked when rehabilitation was initiated within the first year after TBI. The effects of age of TBI were also evaluated. Although RS were most marked in younger patients, improvements in outcome measures were observed in all age groups after post-acute rehabilitation.

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“…Sander et al (2002) found that family functioning was associated with client outcome in a residential post-acute program. Ashley et al (1993) found that gains in Independent Living Scale scores and Disability Rating Scale scores were associated with length of stay and cost of a post-acute program.…”

Section: Introductionmentioning

confidence: 97%

“…Ashley et al (1993) found that payer source was associated with differential gains in a post-acute program. These results suggest that different subpopulations and program characteristics are responsible for differential outcomes of post-acute programs.…”

Section: Introductionmentioning

confidence: 98%

Validity and reliability of the Community Integration Program Questionnaire

Glenn

Goldstein

Selleck

et al. 2006

International Journal of Rehabilitation Research

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The Community Integration Program Questionnaire was developed to measure various quantifiable characteristics of community integration programs for people with brain injury. There are three versions: one for outpatient facility-based, one for residential and one for home programs. In this study questionnaires were administered to directors and associate directors of seven programs. A research assistant then went on-site to collect corresponding data using patient records, planning books and schedules, annual and quarterly reports, employee lists, staff curricula vitae, census data, insurance payment data, team meeting notes, incident reports, and staff logs. Matching criteria between questionnaire and on-site data were established before either was collected. The survey data matched data acquired on-site in 42.2, 56.4, and 56.8% of questions in the three versions, respectively. Interviewers and a second listener recorded the same information 91.5% of the time across seven program interviews. For two programs, comparisons between a Program Director and Program Coordinator yielded matches on 42.8 and 40.6% of questions, respectively. In conclusion, the Community Integration Program Questionnaire does not have acceptable construct validity and inter-rater reliability. Researchers requiring information about quantifiable characteristics of community integration programs should go on-site to collect the data.

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Changes in reimbursement climate: Relationship among outcome, cost, and payor type in the postacute rehabilitation environment

Cited by 18 publications

References 0 publications

Outcomes of post-acute rehabilitation for persons with brain injury

Outcomes of post-acute rehabilitation for persons with brain injury

Post-Acute Traumatic Brain Injury Rehabilitation: Effects on Outcome Measures and Life Care Costs

Validity and reliability of the Community Integration Program Questionnaire

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