For-profit and not-for-profit inpatient rehabilitation in traumatic brain injury: Analysis of demographics and outcomes

Model System:

TBI

Reference Type:

Journal article

Accession No.:

J89017

Journal:

Archives of Physical Medicine and Rehabilitation

Year, Volume, Issue, Page(s):

2022 , 103, 5, 851-857

Publication Website:

Abstract:

Study examined differences in demographics, medical characteristics, and outcomes of patients with traumatic brain injury by inpatient rehabilitation facility (IRF) profit status. Data for 53,630 individual discharges from 877 distinct rehabilitation facilities for calendar years 2016 through 2018 were obtained from the Uniform Data System for Medical Rehabilitation. Patient demographic data (age, race, primary payer source); admission and discharge Functional Independence Measure (FIM); FIM gain; length of stay efficiency; acute hospital readmission from for-profit and not-for-profit IRFs within 30 days; and community discharges by facility profit status were analyzed. Compared to not-for-profit facilities, patients at for-profit facilities were significantly older (69.69 vs 64.12 years), with lower admission FIM scores (52 vs 57), shorter lengths of stay (13 vs 15 days), and higher discharge FIM scores (88 vs 86). For-profit facilities had higher rates of community discharges (76.8 vs 74.6 percent) but also had higher rates of readmission (10.3 vs 9.9 percent) than not-for-profit facilities. Patients at for-profit facilities are more likely to self-identify as White and are more likely to be Medicare beneficiaries. These differences likely reflect a combination of factors, including facility behavioral incentives within contemporary payment systems.

Author(s):