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Application of functional independence measure-function related groups and resource utilization groups-version III
T B Eilertsen1, A M Kramer, R E Schlenker
1University of Colorado Health Sciences Center, Center on Aging Research Section, Denver 80206, USA. Terry.Eilertsen@UCHSC.edu
Medical Care
|May 22, 1998
Summary
The Functional Independence Measure-Function Related Groups (FIM-FRGs) system effectively classifies rehabilitation patients but not skilled nursing facility patients. Further research is needed for a unified patient classification system for subacute care settings.
Area of Science:
- Healthcare Management
- Rehabilitation Medicine
- Health Services Research
Background:
- Accurate patient classification is crucial for resource allocation and care planning in post-acute settings.
- Existing systems like Functional Independence Measure-Function Related Groups (FIM-FRGs) and Resource Utilization Groups-Version III (RUG-III) have limitations in diverse care environments.
- Subacute care encompasses both skilled nursing facilities (SNFs) and rehabilitation facilities (Rehabs), requiring adaptable classification tools.
Purpose of the Study:
- To evaluate the validity of alternative patient classification systems for skilled nursing facility and rehabilitation facility patients.
- To assess the applicability of the FIM-FRGs and RUG-III systems in different post-acute care settings.
- To identify potential improvements for patient classification in subacute care.
Main Methods:
- Utilized data from a national longitudinal study of subacute care, including 513 hip fracture and 483 stroke patients from 27 Rehabs and 65 SNFs.
- Replicated and tested the FIM-FRGs system on length of stay and resource use for both Rehab and SNF patients.
- Assessed modified FIM-FRGs and the RUG-III system for Rehab patients.
Main Results:
- The FIM-FRGs explained significant variance in length of stay and resource use for Rehab patients, comparable to its original development.
- A modified FIM-FRGs demonstrated improved prediction of length of stay and resource use in Rehab patients.
- Neither the FIM-FRGs nor RUG-III adequately predicted outcomes for SNF patients, indicating poor applicability.
- RUG-III explained minimal variance in per-diem resource use for Rehab patients.
Conclusions:
- The FIM-FRGs system is valid for classifying Rehab patients regarding length of stay and resource use.
- The FIM-FRGs and RUG-III systems are not suitable for classifying SNF patients.
- Development of a single, episode-based patient classification system applicable to both SNF and Rehab patients is recommended.