Gp. Prigatano et al., PRESCRIBED VERSUS ACTUAL LENGTH OF STAY AND INPATIENT NEUROREHABILITATION OUTCOME FOR BRAIN DYSFUNCTIONAL PATIENTS, Archives of physical medicine and rehabilitation, 78(6), 1997, pp. 621-629
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.