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Characterization of Cancer Patients in Inpatient Rehabilitation Facilities: A Retrospective Cohort Study
Jacqueline M Mix1, Carl V Granger2, Michael J LaMonte3
1Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA.
Objectives:
To identify the types of cancer patients admitted to inpatient medical rehabilitation and to describe their rehabilitation outcomes.
Design:
Retrospective cohort study.
Setting:
U.S. inpatient rehabilitation facilities (IRFs).
Participants:
Adult patients (N=27,952) with a malignant cancer diagnosis admitted to an IRF with a cancer-related impairment between October 2010 and September 2012 were identified from the Uniform Data System for Medical Rehabilitation database.
Interventions:
Not applicable.
Main Outcome Measures:
Demographic, medical, and rehabilitation characteristics for patients with various cancer tumor types were summarized using data collected from the Inpatient Rehabilitation Facility-Patient Assessment Instrument. Rehabilitation outcomes included the percentage of patients discharged to the community and acute care settings, and functional change from admission to discharge. Functional status was measured using the FIM instrument.
Results:
Cancer patients constituted about 2.4% of the total IRF patient population. Cancer types included brain and nervous system (52.9%), digestive (12.0%), bone and joint (8.7%), blood and lymphatic (7.6%), respiratory (7.1%), and other (11.7%). Overall, 72% were discharged to a community setting, and 16.5% were discharged back to acute care. Patients with blood and lymphatic cancers had the highest frequency of discharge back to acute care (28%). On average, all cancer patient groups made significant functional gains during their IRF stay (mean FIM total change ± SD, 23.5±16.2).
Conclusions:
In a database representing approximately 70% of all U.S. patients in IRFs, we found that patients with a variety of cancer types are admitted to inpatient rehabilitation. Most cancer patients admitted to IRFs were discharged to a community setting and, on average, improved their function. Future research is warranted to understand the referral patterns of admission to postacute care rehabilitation and to identify factors that are associated with rehabilitation benefit in order to inform the establishment of appropriate care protocols.
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