Research and data systems to promote equal access to postacute rehabilitation

The first national study in Israel of post-acute rehabilitation service use for elderly patients with stroke and hip fracture reported regional variation in care receipt. Although lower likelihood of admission to inpatient rehabilitation was observed in districts with known shortages of rehabilitation beds, supply alone did not explain the findings. This commentary explores other potential contributing factors. It argues that greater uniformity in the process and documentation of discharge planning in combination with decision support would help to standardize provider behavior. Implementation of a system of functional status data collection that is linked to administrative data is recommended to enable examination of the impact of care receipt and variation. Additional research is needed to provide a clearer understanding of factors contributing to regional variation and to identify solutions to ensure equal access to post-acute rehabilitation services in Israel.