Variation in inpatient rehabilitation utilization after hospitalization for burn injury in the United States

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Study analyzed the variation in rehabilitation utilization by state of hospitalization for patients hospitalized with burn injury. This retrospective cohort study used nationally collected data over a 10-year period (2001 to 2010), from the Healthcare Cost and Utilization Project State Inpatient Databases. A total of 57,968 patients hospitalized for burn injury were identified by ICD-9-CM codes and examined to see specifically if they were discharged immediately to inpatient rehabilitation after hospitalization (primary outcome). Both unadjusted and adjusted likelihoods were calculated for each state taking into account the effects of age, insurance status, hospitalization at a burn center, and extent of burn injury by total body surface area (TBSA). The relative risk of discharge to inpatient rehabilitation varied by as much as 6-fold among different states. Higher TBSA, having health insurance, higher age, and burn center hospitalization all increased the likelihood of discharge to inpatient rehabilitation following acute care hospitalization. There was significant variation between states in inpatient rehabilitation utilization after adjusting for variables known to affect each outcome. The authors recommend that future efforts focus on identifying the cause of this state-to-state variation, its relationship to patient outcome, and standardizing treatment across the United States.

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