Journal:Journal of Spinal Cord Medicine
Year, Volume, Issue, Page(s):11, 34, 2, 133-148
Study examined the time spent on rehabilitation treatments for patients treated by specialty rehabilitation inpatient programs. Data were collected from 600 patients with traumatic SCI admitted to six rehabilitation centers during the first year of enrollment in the SCIRehab project. Time spent on various therapeutic activities was documented by each rehabilitation clinician after each patient encounter. Patients were grouped by neurologic level and completeness of injury. Total time spent by each rehabilitation discipline over a patient's stay and total minutes of treatment per week were calculated. Ordinary least squares stepwise regression models were used to identify patient and injury characteristics associated with time spent in rehabilitation treatment overall and within each discipline. Results indicated that the average length of stay (LOS) was 55 days, during which 180 hours of treatment were received, or 24 hours per week. Extensive variation was found in the amount of treatment received, between and within neurologic groups. Total hours of treatment provided throughout a patient's stay were primarily determined by LOS, which in turn was primarily predicted by medical acuity. Variation in treatment intensity was not well explained by patient and injury characteristics. In accordance with practice-based evidence methodology, the next step in the SCIRehab study will be to determine which treatment interventions are related with positive outcomes (at 1 year post injury), after controlling for patient and injury differences.