CAN CLINICAL-PRACTICE GUIDELINES INCREASE THE COST-EFFECTIVENESS OF GERIATRIC REHABILITATION

The need for guidelines stems from the human and economic burdens of d isabilities, from variations in practice patterns, and from controvers y over the effectiveness of rehabilitation. This article describes the development of the stroke rehabilitation guidelines and highlights se veral recommendations that have implications for geriatric rehabilitat ion more generally. It then describes a pilot test of resulting review criteria and a study in progress that is examining the extent to whic h rehabilitation referrals after acute strokes follow guideline recomm endations. Finally, it closes by underscoring several policy challenge s that will be critical to achieving more cost-effective use of rehabi litation resources.