Portal de Periódicos da CAPES

Efficacy of 7 Days per Week Inpatient Admissions and Rehabilitation Therapy

2012; Elsevier BV; Volume: 93; Issue: 12 Linguagem: Inglês

10.1016/j.apmr.2012.07.003

1532-821X

Marie P. Disotto-Monastero, Xiaohong Chen, Shelby Fisch, Siobhan Donaghy, Manuel Gómez,

Cerebral Palsy and Movement Disorders

DiSotto-Monastero M, Chen X, Fisch S, Donaghy S, Gomez M. Efficacy of 7 days per week inpatient admissions and rehabilitation therapy. Objective To evaluate the efficacy of 7d/wk of inpatient admissions and rehabilitation therapy (7DART) in a rehabilitation hospital. Design Cross-sectional, retrospective electronic data review. Setting Rehabilitation hospital. Participants Adult patients who participated in the 7DART program and were admitted and discharged between February 2009 and January 2010 (n=1808), and adult patients who received 5d/wk of inpatient admissions and rehabilitation therapy (5DART), and were admitted and discharged between February 2008 and January 2009 (n=1692). Interventions Occupational therapy and physiotherapy during the weekends (7DART only). Main Outcome Measures FIM rating change from admission to discharge, length of hospital stay, rehabilitation workload per patient, and discharge destination. Results There were 3500 patients admitted with a mean age ± SD of 72.1±13.3 years and a male-to-female ratio of 1:1.9. Under 7DART conditions, there was a 6.9% increase in admissions (7DART=1808 vs 5DART=1692, P=.006), an 86% increase in weekend admissions (255 vs 137, P<.001), a 13.2% increase in rehabilitation workload per patient (40.7h vs 36h, P<.001), and a 5.4% decrease in rehabilitation hospital stay (19.3d vs 20.3d, P=.043). Similar FIM rating changes were obtained from admission to discharge under both conditions (18.2 for 7DART vs 18.7 for 5DART, P=.099). Both groups resulted in 94% of patients achieving their rehabilitation goals (7DART=94.1%, 5DART=94.5%; P=.967), and 88.6% of patients returning to their homes (7DART=88.1%, 5DART=89.2%; P=.334). Conclusions Despite the fact that patients in both groups had similar functional outcomes and discharge destination, the 7DART rehabilitation model reduced length of hospital stay and increased rehabilitation workload, demonstrating increased efficiency and access to care by admitting more patients from acute care, rehabilitating them, and discharging them to the community in less time than the 5DART model.