ArticleArchives of physical medicine and rehabilitation2015
Geographic and facility variation in inpatient stroke rehabilitation: multilevel analysis of functional status.
Article in Archives of physical medicine and rehabilitation, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Built environments for inpatient stroke rehabilitation services and care: a systematic literature review.BMJ open · 2021Pooled it
- Postacute Care Setting, Facility Characteristics, and Poststroke Outcomes: A Systematic Review.Archives of physical medicine and rehabilitation · 2018Pooled it
- Social determinants of health and rehabilitation service areas: an urban and rural mediation analysis.Frontiers in public health · 2025Observational
- Regional variation in length of stay for stroke inpatient rehabilitation in traditional Medicare and Medicare Advantage.Health affairs scholar · 2024Article
- Multi-Site Identification and Generalization of Clusters of Walking Behaviors in Individuals With Chronic Stroke and Neurotypical Controls.Neurorehabilitation and neural repair · 2023Article
- Built Environments to Support Rehabilitation for People With Stroke From the Hospital to the Home (B-Sure): Protocol for a Mixed Method Participatory Co-Design Study.JMIR research protocols · 2023Article
- Multi-site identification and generalization of clusters of walking behaviors in individuals with chronic stroke and neurotypical controls.bioRxiv : the preprint server for biology · 2023Article
- Post-Acute Care in Inpatient Rehabilitation Facilities Between Traditional Medicare and Medicare Advantage Plans Before and During the COVID-19 Pandemic.Journal of the American Medical Directors Association · 2023Article
- Article
- Development and Evaluation of Rehabilitation Service Areas for the United States.BMC health services research · 2023Article
- Non-human and human service efficiency of long-term care facilities in China.Frontiers in public health · 2023Article
- Understanding Variation in Postacute Care: Developing Rehabilitation Service Areas Through Geographic Mapping.American journal of physical medicine & rehabilitation · 2021Article
- Assessment of Differences in Inpatient Rehabilitation Services for Length of Stay and Health Outcomes Between US Medicare Advantage and Traditional Medicare Beneficiaries.JAMA network open · 2020Article
- Post-acute care referral in United States of America: a multiregional study of factors associated with referral destination in a cohort of patients with coronary artery bypass graft or valve replacement.BMC medical informatics and decision making · 2019Article
- Discharge Patterns for Ischemic and Hemorrhagic Stroke Patients Going From Acute Care Hospitals to Inpatient and Skilled Nursing Rehabilitation.American journal of physical medicine & rehabilitation · 2018Article
- Successful Community Discharge Following Postacute Rehabilitation for Medicare Beneficiaries: Analysis of a Patient-Centered Quality Measure.Health services research · 2018Article
- Length of Stay and Functional Outcomes Among Patients with Stroke Discharged from an Inpatient Rehabilitation Facility in Saudi Arabia.Medical science monitor : international medical journal of experimental and clinical research · 2018Article
- Article
- Variation in Functional Status After Hip Fracture: Facility and Regional Influence on Mobility and Self-Care.The journals of gerontology. Series A, Biological sciences and medical sciences · 2017Article
- Biomedical informatics advancing the national health agenda: the AMIA 2015 year-in-review in clinical and consumer informatics.Journal of the American Medical Informatics Association : JAMIA · 2017Review
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveTo examine geographic and facility variation in cognitive and motor functional outcomes after postacute inpatient rehabilitation in patients with stroke.
designRetrospective cohort design using Centers for Medicare and Medicaid Services (CMS) claims files. Records from 1209 rehabilitation facilities in 298 hospital referral regions (HRRs) were examined. Patient records were analyzed using linear mixed models. Multilevel models were used to calculate the variation in outcomes attributable to facilities and geographic regions.
settingInpatient rehabilitation units and facilities.
participantsPatients (N=145,460) with stroke discharged from inpatient rehabilitation from 2006 through 2009.
interventionNot applicable.
main outcome measuresCognitive and motor functional status at discharge measured by items in the CMS Inpatient Rehabilitation Facility-Patient Assessment Instrument.
resultsVariation profiles indicated that 19.1% of rehabilitation facilities were significantly below the mean functional status rating (mean ± SD, 81.58±22.30), with 221 facilities (18.3%) above the mean. Total discharge functional status ratings varied by 3.57 points across regions. Across facilities, functional status values varied by 29.2 points, with a 9.1-point difference between the top and bottom deciles. Variation in discharge motor function attributable to HRR was reduced by 82% after controlling for cluster effects at the facility level.
conclusionsOur findings suggest that variation in motor and cognitive function at discharge after postacute rehabilitation in patients with stroke is accounted for more by facility than geographic location.
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