PREDICTING PATIENT SCORES BETWEEN THE FUNCTIONAL INDEPENDENCE MEASUREAND THE MINIMUM DATA SET - DEVELOPMENT AND PERFORMANCE OF A FIM-MDS CROSSWALK

Objective: The functional status of rehabilitation patients is often m easured using the Functional Independence Measure (FIM) in acute rehab ilitation settings or the Minimum Data Set (MDS) in nursing homes. Bec ause the relationship between the two instruments is unknown, preventi ng comparison of rehabilitation patients in different types of setting s, a translation formula (''crosswalk'') between items and subscales f rom the FIM and the MDS was developed and tested. Design and Outcome M easures: Using definitions recommended by an expert panel, MDS items w ere chosen and rescaled (termed ''Pseudo-FIM(E)'' items) to correspond to FlM items. The empiric relationships between Pseudo-FIM(E) and FIM scores were then measured using paired FIM-MDS assessments. Setting a nd Patients: 173 rehabilitation patients admitted to six nursing homes . Results: Pseudo-FIM(E) items could be defined for 12 of the 18 FIM i tems (8 motor and 4 cognitive items). Mean FIM and Pseudo-FIM(E) score s were not significantly different (p > .30) for 5 of the 12 items. Me an scores for the remaining 7 items and for motor and cognitive subsca les were similar but statistically significantly different (p < .05). Intraclass correlation coefficients between the FIM and Pseudo-FIM(E) motor and cognitive subscales were both .81. Conclusions: FIM and MDS items can be used to predict item and subscale scores between the two instruments with reasonable accuracy. This capability will enhance eff orts to compare case-mix between acute rehabilitation and nursing home rehabilitation patients, thus making feasible comparisons of the effe ctiveness (degree of improvement among similar patients) and efficienc y (cost of care to obtain a given degree of improvement) of rehabilita tion care in different types of settings. (C) 1997 by the American Con gress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation