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Inpatient rehab

Douglas E Padgett, Alexander B Christ, Amethia D Joseph, You-Yu Lee, Stephen B Haas, Stephen Lyman
BACKGROUND: Monitored rehabilitation has long been considered an essential part of the recovery process in total knee arthroplasty (TKA). However, the optimal setting for rehabilitation remains uncertain. We sought to determine whether inpatient rehabilitation settings result in improved functional and patient-reported outcomes after primary TKA. METHODS: All patients undergoing primary TKA from May 2007 to February 2011 were identified from our institutional total joint registry...
December 28, 2017: Journal of Arthroplasty
Sarmistha Pal, Morad Chughtai, Assem A Sultan, Anton Khlopas, Nipun Sodhi, Nicole E George, Jennifer I Etcheson, Chukwuweike U Gwam, Jared M Newman, Linsen T Samuel, Anil Bhave, Joan E DaVanzo, Michael A Mont
INTRODUCTION: This study evaluated differences in: 1) total episode payments, 2) probability of hospital readmission, 3) probability of inpatient rehab facility (IRF) and utilization, and 4) probability of skilled nursing care facility (SNF) utilization in patients who had disuse atrophy and underwent a total knee arthroplasty (TKA) and either did, or did not, receive preoperative home-based neuromuscular electrical stimulation (NMES) therapy. MATERIALS AND METHODS: We used the Medicare limited dataset for a 5% sample of beneficiaries from 2014 and 2015 to construct episodes-of-care for TKA (DRG-470) patients with disuse atrophy who underwent a TKA during the 30 days prior to hospital admission and 90 days post-discharge...
December 22, 2017: Surgical Technology International
Nathan Esplin, John W Stelzer, Sean All, Sundeep Kumar, Ejaz Ghaffar, Sayed Ali
Brain abscesses are infections of the brain parenchyma that can arise from either contiguous spread from local infection or by hematogenous spread from a distant site. Streptococcus anginosus of the Streptococcus anginosus group (SAG) is a commensal microbe of the mucosae of the oral cavity, gastrointestinal tract, and urogenital tract. We present a case of mono-microbial brain abscess caused by contiguous spread from relatively asymptomatic sinusitis that initially presented as a subdural hemorrhage on computed tomography...
October 4, 2017: Curēus
Charissa Levy, Sharon Ocampo-Chan, Linda Huestis, Donna Renzetti
Evidence suggests that patients with hip fractures should begin rehabilitation no later than six days following surgery. The reality is often far different. In an initiative led by the Greater Toronto Area (GTA) Rehab Network, acute care and rehab/complex continuing care hospitals across the GTA have implemented a new early referral process to aid transition of patients from acute care to inpatient rehabilitation as early as possible to improve their outcomes. Two of the participating acute care hospitals have now surpassed the six-day target and two others are within range...
2017: Healthcare Quarterly
Matthew J McGirt, Scott L Parker, Silky Chotai, Deborah Pfortmiller, Jeffrey M Sorenson, Kevin Foley, Anthony L Asher
OBJECTIVE Extended hospital length of stay (LOS), unplanned hospital readmission, and need for inpatient rehabilitation after elective spine surgery contribute significantly to the variation in surgical health care costs. As novel payment models shift the risk of cost overruns from payers to providers, understanding patient-level risk of LOS, readmission, and inpatient rehabilitation is critical. The authors set out to develop a grading scale that effectively stratifies risk of these costly events after elective surgery for degenerative lumbar pathologies...
October 2017: Journal of Neurosurgery. Spine
A Leonard
CASE: A 44 year old woman with a history of stroke s/p aneurysm clipping, seizure, and substance abuse was brought to the hospital after a family member received a call from her friend saying she was acting unusual and may have had a seizure while hanging out on the street. At her baseline, she needed modest assistance in daily activities after her CVA and conversed without issue. Her mother died of a stroke. On exam the patient was afebrile, normotensive with mild tachycardia to 110...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Alexandra Hudson, Sarah Al Youha, Osama A Samargandi, Justin Paletz
OBJECTIVE: To compare patient and burn characteristics between patients who had a pre-existing psychiatric diagnosis and patients who did not in a Burn Unit at an academic hospital. BACKGROUND: Psychosocial issues are common in patients recovering from a burn; however, little is known regarding hospital course and discharge outcomes in patients with a pre-existing psychiatric diagnosis presenting with a burn. Baseline medical comorbidities of burn patients have been shown to be a significant risk for in-hospital mortality...
August 2017: Burns: Journal of the International Society for Burn Injuries
(no author information available yet)
No abstract text is available yet for this article.
April 2017: AORN Journal
Charles Benaim, Bertrand Léger, Philippe Vuistiner, François Luthi
Background. The "Patterns of Activity Measure" (POAM-P) is a self-administered questionnaire that assesses "avoidance", "pacing" and "overdoing" activity patterns in chronic pain patients. Objectives. To adapt the POAM-P to French ("POAM-P/F") and test its validity and reliability in Chronic Musculo-Skeletal Pain patients (CMSP). Methods. We followed the recommended procedure for translation of questionnaires. Five hundred and ninety five inpatients, admitted to a tertiary rehab center in the French-speaking part of Switzerland for chronic pain after orthopedic trauma, were included (sex ratio M/F = 4...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
Matthew A Varacallo, Leah Herzog, Nader Toossi, Norman A Johanson
BACKGROUND: Total joint arthroplasty procedures continue to provide consistent, long-term success and high patient satisfaction scores. However, early unplanned readmission to the hospital imparts significant financial risks to individual institutions as we shift away from the traditional fee-for-service payment model. METHODS: Using a combination of our hospital's administrative database and retrospective chart reviews, we report the 30-day and 90-day readmission rates and all causes of readmission following all unilateral, primary elective total hip and knee arthroplasty procedures at a large, urban, academic hospital from 2004 to 2013...
December 27, 2016: Journal of Arthroplasty
Laura N Medford-Davis, Gregg C Fonarow, Deepak L Bhatt, Haolin Xu, Eric E Smith, Robert Suter, Eric D Peterson, Ying Xian, Roland A Matsouaka, Lee H Schwamm
BACKGROUND: Insurance status affects access to care, which may affect health outcomes. The objective was to determine whether patients without insurance or with government-sponsored insurance had worse quality of care or in-hospital outcomes in acute ischemic stroke. METHODS AND RESULTS: Multivariable logistic regressions with generalized estimating equations stratified by age under or at least 65 years were adjusted for patient demographics and comorbidities, presenting factors, and hospital characteristics to determine differences in in-hospital mortality and postdischarge destination...
November 14, 2016: Journal of the American Heart Association
Derenda Lovelace, Diane Hancock, Sabrina S Hughes, Phyllis R Wyche, Claire Jenkins, Cindy Logan
BACKGROUND: In 2011, the Hunter Holmes McGuire Veterans Administration Medical Center (VAMC) in Richmond, VA, had a cumulative readmission rate and emergency department (ED) revisits for discharged Veterans of 1 in 5. In 2012, a transitional care program (TCP) was implemented to improve care coordination and outcomes among Veterans, with an emphasis on geriatric patients with chronic disease. This TCP was created with an interdisciplinary approach using intensive case management interventions, with a goal of reducing Veteran ED and hospital revisits by 30%...
November 2016: Professional Case Management
Jean-Pascal Devailly, Laurence Josse
OBJECTIVE: In all countries, the boundaries are ambiguous between acute and post-acute as well as defining the dimensions of care. The aim of this study is to analyze relations between segmentation of care and payment systems. In the new prospective payment system implemented in French SSR, the grouping unit is inpatient stay and the week for day hospitalization. In 1991, the field of SSR mixed structures as diverse in their purposes as public or private hospital units of rehabilitation and "nursing homes"...
September 2016: Annals of Physical and Rehabilitation Medicine
Johanna Morgounovski, Philippe Vuistiner, Bertrand Léger, François Luthi
OBJECTIVE: The fear-avoidance model (FAM) is commonly used in musculoskeletal chronic pain (Vlaeyen 2012). Nevertheless, only few prospective studies have been conducted, especially on return to work (RTW). This study lays the hypothesis that the components of the FAM (catastrophizing, kinesiophobia and depression) can predict RTW 1 year after a vocational rehabilitation for orthopedic trauma patients. MATERIAL/PATIENTS AND METHODS: A total of 323 rehab orthopedic trauma inpatients (average time after accident: 9 months) were included...
September 2016: Annals of Physical and Rehabilitation Medicine
Jeremy A Jacobs
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Kyle A Aman, Mohammad Aalai
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
A Hüppe, G Steimann, M Janotta, J Langbrandtner, N Eisemann, B Bokemeyer, H Raspe
BACKGROUND: Many CED-patients struggle with complex problem profiles and may be offered and profit from multidisciplinary multimodal rehabilitation. It is still unclear by whom and with what effects this option is used. METHODS: We compared the results of an observational cohort study of 199 CED-inpatients of a single rehab clinic with those of 310 gastroenterological outpatients using propensity score matching. RESULTS: Rehabilitands show more complex problem profiles than CED-outpatients...
August 2016: Die Rehabilitation
Coles E L'Hommedieu, James J Gera, Gerald Rupp, Jeffery W Salin, John S Cox, Paul J Duwelius
BACKGROUND: Controversy exists as to which surgical approach is best for total hip arthroplasty (THA). Previous studies suggested that the tissue-sparing anterior approach should result in a more rapid recovery requiring fewer postacute services, ultimately decreasing overall episodic cost. The purpose of this cross-sectional study was to determine if any significant differences exist between the anterior vs posterior approaches on postacute care service utilization, readmissions, or episodic cost...
September 2016: Journal of Arthroplasty
Manuel Gomez, Morris Tushinski, Marc G Jeschke
On July 2012, a rehabilitation hospital merged with a trauma center where the regional burn center is located. That rehabilitation center provides the only burn rehabilitation program in our region. The objective of this study was to determine if earlier initiation of inpatient rehabilitation after merger had an effect on burn survivors' functional outcomes and resource utilization. A retrospective review of electronic data of burn survivors' functional outcomes (functional independence measure [FIM] ratings on admission, at discharge, and percent change), and resource utilization (waiting time for rehab, burn center length of stay [LOS], rehab LOS, physiotherapy and occupational therapy rehabilitation workload [RehabWorkload], and discharge destination) was undertaken...
January 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Maria G Benedetti, Silayan Erfe Delayon, Marco Colangeli, Federica Parisini, Stefano Ferrari, Marco Manfrini, Isabella Springhetti
BACKGROUND: Rehabilitation plays an important role in improving functional outcome in patients operated on musculoskeletal tumors. Literature in the field is scarce and the specific needs for rehabilitation of these patients are still unknown. AIM: To analyze the rehabilitation needs of patients with primary malignant musculoskeletal tumors. DESIGN: Observational, longitudinal study on both inpatient and outpatient operated on musculoskeletal tumors...
February 2017: European Journal of Physical and Rehabilitation Medicine
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