A Characterization of Cancer Patients in Inpatient Rehabilitation Facilities: A Retrospective Cohort Study

Publication date: Available online 1 February 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Jacqueline M. Mix, Carl V. Granger, Michael J. LaMonte, Paulette Niewczyk, Margaret DiVita, Richard Goldstein, Jerome Yates, Jo L. Freudenheim
ObjectiveTo identify the types of cancer patients admitted to inpatient medical rehabilitation and to describe their rehabilitation outcomes.DesignRetrospective cohort study;SettingU.S. inpatient rehabilitation facilities (IRFs)ParticipantsAdult patients diagnosed with malignant cancer for a cancer related impairment admitted to an IRF between October 2010 and September 2012 were identified from the Uniform Data System for Medical Rehabilitation (UDSMR) database (n = 27,952).InterventionsnoneMain Outcome Measure(s)Demographic, medical and rehabilitation characteristics for patients with various cancer tumor types were summarized using data collected from the Inpatient Rehabilitation Patient Assessment Instrument (IRF-PAI). Rehabilitation outcomes included the percentage of patients discharged to community and acute care settings and functional change from admission to discharge. Functional status was measured using the FIM® instrument.ResultsCancer 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 gain during their IRF stay (FIM total change: 23.5 ± 16.2).ConclusionsIn a database representing approximately 70% of all US patients in IRFs, we found that a variety of cancer types are admitted to inpatient rehabilitation. The majority of 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 post-acute 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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