Journal ArticleDOI
Trends in inpatient rehabilitation stroke outcomes before and after advent of the prospective payment system: a systematic review.
TLDR
The impact of PPS on quality care indicators for inpatient stroke rehabilitation, trends for LOS, and trends for functional outcomes are insufficiently documented in the medical literature.Abstract:
BACKGROUND AND PURPOSE The purpose of this systematic review was to examine quality care indicators for inpatient stroke rehabilitation, trends for length of stay (LOS), functional outcomes, and discharge destination. In order to examine the influence of the prospective payment system (PPS), which was instituted in 2002, particular attention was paid to the pre-PPS to post-PPS period. This is the first review of literature to examine the quality of stroke care provided in inpatient rehabilitation facilities in the United States. METHODS A search of Ovid Medline and Ovid Cumulative Index of Nursing and Allied Health databases was performed for articles published between 1990 and 2007. Search terms included treatment outcome, outcome assessment, activities of daily living, exercise, rehabilitation, cerebrovascular accident, LOS, and rehabilitation centers. RESULTS Twelve articles met the criteria for review. A trend for shorter LOS was evident in the literature up until the time of implementation of PPS. An insufficient amount of literature was available to confirm whether this trend continued after the implantation of PPS. The most recent data indicated that average LOS in inpatient rehabilitation facilities for stroke was <20 days. Functional Independence Measure (FIM) discharge scores remained stable through the 1990s. After the implementation of PPS, discharge FIM scores may be decreasing, but revisions to the FIM tool may confound interpretation of post-PPS findings. Data for discharge to noninstitutional settings after stroke rehabilitation were inconclusive pre-PPS. There may be indications that discharges to institutional settings are increasing post-PPS. CONCLUSIONS The impact of PPS on quality care indicators for inpatient stroke rehabilitation, trends for LOS, and trends for functional outcomes are insufficiently documented in the medical literature. Further research is needed to understand the influence of LOS on functional outcomes and discharge destination. More information is needed on post-PPS outcomes to substantiate the benefit of inpatient rehabilitation for individuals with stroke.read more
Citations
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Journal ArticleDOI
Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association
Carolee J. Winstein,Joel M. Stein,Ross Arena,Barbara E. Bates,Leora R. Cherney,Steven C. Cramer,Frank DeRuyter,Janice J. Eng,Beth E. Fisher,Richard L. Harvey,Catherine E. Lang,Marilyn MacKay-Lyons,Kenneth J. Ottenbacher,Sue Pugh,Mathew J. Reeves,Lorie Richards,William Stiers,Richard D. Zorowitz +17 more
TL;DR: This guideline provides a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke to reduce the risk of downstream medical morbidity resulting from immobility, depression, loss of autonomy, and reduced functional independence.
Journal ArticleDOI
The crisis of stroke: experiences of patients and their family caregivers.
TL;DR: Findings from this study suggest that as caregivers move through the phases of the trajectory, they do not have a good understanding of the role to which they are committing, and they are often underprepared to take on even the basic tasks to meet the patients’ needs on discharge.
Journal ArticleDOI
Shorter Length of Stay Is Associated With Worse Functional Outcomes for Medicare Beneficiaries With Stroke
TL;DR: In this article, a serial, cross-sectional analysis of the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) dataset was conducted to examine the trends and associations between LOS and discharge outcomes in Medicare beneficiaries with stroke treated in inpatient rehabilitation facilities (IRFs).
Journal ArticleDOI
Home-based transcranial direct current stimulation plus tracking training therapy in people with stroke: an open-label feasibility study.
Ann Van de Winckel,James R. Carey,Teresa Bisson,Elsa Hauschildt,Christopher Streib,William K. Durfee +5 more
TL;DR: stDCS with finger tracking training delivered through telerehabilitation was safe, feasible, and has the potential to be a cost-effective home-based therapy for post-stroke motor rehabilitation.
Journal ArticleDOI
Nursing roles and functions addressing relatives during in-hospital rehabilitation following stroke. Care needs and involvement.
Lena Aadal,Sanne Angel,Sanne Angel,Leanne Langhorn,Birgitte Blicher Pedersen,Pia Dreyer,Pia Dreyer +6 more
TL;DR: Nurses experience their roles and functions addressing relatives after stroke as crucial, challenging and multifaceted but do not perceive that teaching of relatives is a task they should routinely undertake.
References
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Journal Article
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Journal ArticleDOI
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