PRESCRIBED VERSUS ACTUAL LENGTH OF STAY AND INPATIENT NEUROREHABILITATION OUTCOME FOR BRAIN DYSFUNCTIONAL PATIENTS

Objective: To determine (1) whether brain dysfunctional patients have better rehabilitation outcomes if they receive prescribed length of st ay (LOS) versus less than prescribed and (2) if LOS and cognitive stat us relate to goal attainment. Design: Prospective inception cohort stu dy. Study Setting: Medical center and a neurological institute. Partic ipants: One hundred six patients with acute static brain lesions. Main Outcome Measures: Documentation of goal attainment at discharge and m aintenance of goals 6 months after discharge. All subjects also receiv ed neuropsychological tests at admission and discharge. Results: Patie nts who received prescribed LOS achieved their rehabilitation goals at discharge more frequently than patients who received less than prescr ibed LOS. There was, however, no difference between groups as to maint enance of rehabilitation goals 6 months after discharge. There was no relation between number of days spent in neurorehabilitation and numbe r of goals achieved at discharge. Cognitive status at discharge was st rongly related to achieving rehabilitation goals. Conclusion: Although LOS may not specifically relate to goal attainment in a heterogenous group of brain dysfunctional patients, patients who receive the prescr ibed LOS and who show notable improvement in cognitive status tend to achieve rehabilitation goals, compared with patients who do not. (C) 1 997 by the American Congress of Rehabilitation Medicine and the Americ an Academy of Physical Medicine and Rehabilitation.