THE FUNCTIONAL INDEPENDENCE MEASURE IN SWEDEN - EXPERIENCE FOR OUTCOME MEASUREMENT IN REHABILITATION-MEDICINE

The purpose of the study was to describe the Functional Independence M easure (FIM) in Sweden and to analyse some aspects on its structure an d the possibility to predict length of stay in a rehabilitation ward, It assesses the degree of dependence with 13 physical and 5 social and cognitive items, using a 7-level ordinal scale, Data are presented fr om a total of 312 patients and from 267 first admission patients with a mean age of 45 (SD 13) years, 66% being men, in rehabilitation medic ine wards in three hospitals in Sweden, The patients were divided into six diagnostic groups, Ratings were made at admission and at discharg e, The level of dependence in physical and social cognitive items was reduced during the stay at the ward, Using Rasch analysis, separate ph ysical and social-cognitive items and personal measures were obtained on a linear scale, It was demonstrated that the relative order of the items was similar at admission and dis-charge, There mere minor differ ences between diagnostic groups for the physical items, whereas more d iagnostic-specific differences were seen for the social-cognitive item s, for stroke patients, with and without aphasia, Individual statistic s were used for demonstrating FIM changes during the rehabilitation pe riod, There was a high correlation between admission and dis-charge FI M values, and the admission FIM (physical items) accounted for up to n early 50% of the variation in length of stay in a homogeneous sample s uch as stroke patients, but for less than 40% in the total sample, FIM can be used to follow changes during inpatient rehabilitation and for comparisons between different rehabilitation units.