Inpatient arthritis rehabilitation programs in the US: results from a national survey

The implementation of prospective payment systems has severely limited the traditional practice of providing rehabilitation services to arthritis patients on rheumatic disease units; however, the admission of these patients to a designated rehabilitation unit may be appropriate. This paper presents data on the provision of inpatient rehabilitation services to patients with arthritis. Two surveys were developed for this study. The first survey sample consisted of 502 hospitals; 163 (52%) of the 313 respondents were identified as facilities providing inpatient arthritis rehabilitation. A second survey regarding patient and program characteristics was completed by 146 of the 313 facilities. The data from rehabilitation units serving arthritis patients are presented with regard to utilization, discharge disposition, sources of payment, patient demographic and diagnostic information, and specialization of the rehabilitation program. The data indicate that persons with arthritis are underrepresented in the rehabilitation population, although the diagnosis is approved for admission under rehabilitation guidelines. This underutilization is attributed to problems of reimbursement, inappropriate admission criteria, inadequately trained staff, and lack of referrals.