Postacute care services use for dysvascular amputees - A population-based study of Massachusetts
Postacute care services use for dysvascular amputees - A population-based study of Massachusetts
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DOI：
10.1097/01.phm.0000154899.49528.05
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发表时间：
2005-03-01
影响因子：
3
通讯作者：
Pezzin, LE
中科院分区：
文献类型：
--
作者：
Dillingham, TR;Pezzin, LE
目的：康复和其他急性护理服务对因血管障碍而截肢的患者的利用是理疗师、治疗师、患者和卫生政策规划者的重要信息。这项研究的目的是检查全州人口中住院康复服务的使用率。设计：使用1997年马萨诸塞州医院的病例组合和收费数据来选择血管功能障碍的肢体截肢患者。结果：2487例患者中，大多数为白人(94%)、男性(58%)和老年人(69岁)。大多数人有糖尿病(62%)或外周血管疾病(51%)。最常见的倾向是在家(33%)，16%的人在截肢后接受住院康复治疗。截肢者接受住院康复治疗的比例最高，分别为28%和19%。结论：16%的血管功能障碍截肢者接受了住院康复服务。这高于马里兰州1997年的比率(12%)，表明服务利用的地理差异。有必要进行前瞻性研究，以检查在不同护理环境中接受康复服务的人的结果，以确定恢复功能的最佳康复地点。制定更具体的《国际疾病分类》第九版--血管功能障碍截肢的临床修订代码将进一步推动研究和公共政策努力。
Objective: Rehabilitation and other postacute care services utilization for persons with a lower limb amputations due to dysvascular disease is important information for physiatrists, therapists, patients, and health-policy planners. The purpose of this study was to examine rates of inpatient rehabilitation services use in a statewide population.Design: Massachusetts Hospital Case Mix and Charge Data for 1997 were used to select persons with dysvascular limb amputations. Disposition locations after amputation were analyzed.Results: There were 2487 persons who incurred a lower limb amputation, with the majority being white (94%), male (58%), and elderly (69 yrs). Most had diabetes (62%) or peripheral vascular disease (51%). The most common disposition was home (33%), with 16% receiving inpatient rehabilitation after amputation. Persons with transtibial and transfemoral amputations were the most likely to receive inpatient rehabilitation, 28% and 19% respectively.Conclusions: Sixteen percent of dysvascular amputees received inpatient rehabilitation services. This was higher than the 1997 rate for Maryland (12%) and suggests geographic differences in services utilization. Prospective studies are necessary to examine outcomes for persons receiving rehabilitation services in different care settings to define the optimal rehabilitation venue for functional restoration. Development of more specific International Classification of Diseases, Ninth Revision-Clinical Modification codes for dysvascular amputations would further research and public policy efforts.