Association between Self-Reported Participation in Decision Making and Inpatient Rehabilitation Outcomes

Area of Science:

• Rehabilitation Medicine
• Health Services Research
• Patient-Centered Care

Background:

• Active patient engagement in inpatient rehabilitation is crucial for enhancing patient experiences and outcomes.
• Inpatient rehabilitation represents a critical, high-intensity post-acute care service.

Purpose of the Study:

• To evaluate the association between perceived patient participation in clinical decision-making and key outcomes in inpatient rehabilitation.
• To determine if patient involvement in decision-making independently influences length of stay, functional status at discharge, and discharge destination.

Main Methods:

• Retrospective cross-sectional study utilizing data from Medicare beneficiaries discharged from inpatient rehabilitation facilities (2007-2009).
• Combined self-reported participant interview data on decision-making involvement with administrative medical records.
• Analyzed perceived participation in decision-making, length of stay, discharge functional status, and discharge setting.

Main Results:

• Approximately 89% of 41,110 participants reported agreeing or strongly agreeing with their involvement in decision-making.
• Multivariable regression indicated that increased participation in decision-making was associated with slightly longer lengths of stay (p < .05).
• Greater decision-making participation correlated with improved discharge functional status and a higher likelihood of discharge to the community.

Conclusions:

• A significant majority of Medicare beneficiaries perceive active participation in decision-making during inpatient rehabilitation.
• Enhancing patient involvement in the rehabilitation decision-making process may positively impact fundamental rehabilitation outcomes.