Evidence map›Paper›PMID 33002913›Full record

Observational studyAmerican journal of physical medicine & rehabilitation2021

Association Between 2010 Medicare Reforms and Utilization of Postacute Inpatient Rehabilitation in Ischemic Stroke.

Nneka L Ifejika, Farhaan Vahidy, Mathew Reeves, Ying Xian, Li Liang, Roland Matsouaka, Gregg C Fonarow, Sean I Savitz

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in American journal of physical medicine & rehabilitation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 3 countries.

Nneka L IfejikaFrom the Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas (NLI); Department of Neurology and Neurotherapeutics, UT Southwestern Medical Center, Dallas, Texas (NLI); Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, Texas (NLI); Centers for Outcomes Research, Houston Methodist Research Institute, Houston, Texas (FV); Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, Lansing, Michigan (MR); Department of Neurology, Duke University Hospital, Durham, North Carolina (YX); Duke Clinical Research Institute, Durham, North Carolina (YX, LL, RM); Division of Cardiology, Ahmanson - UCLA Cardiomyopathy Center, University of California, Los Angeles Medical Center, Los Angeles, California (GCF); Institute for Stroke and Cerebrovascular Disease, UTHealth, Houston, Texas (SIS); and Department of Neurology, McGovern Medical School at UTHealth, Houston, Texas (SIS).
Farhaan Vahidy
Mathew Reeves
Ying Xian
Li Liang
Roland Matsouaka
Gregg C Fonarow
Sean I Savitz
Star Information Systems (Norway) · NO

Funding

Convalescent Plasma to Limit Coronavirus Associated ComplicationsUL1TR003167 · NCATS · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI KARP, DANIEL D, MCPHERSON, DAVID D · 2019 to 2023
$45.3M
University of Texas Specialized Program in Acute StrokeP50NS044227 · NINDS · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI GROTTA, JAMES C · 2002 to 2012
$17.9M
Center for Clinical and Translational Sciences (CCTS)UL1TR000371 · NCATS · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI MCPHERSON, DAVID D · 2012 to 2016
$13.4M
Center for Clinical and Translational Sciences (CCTS)KL2TR000370 · NCATS · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI MCPHERSON, DAVID D · 2012 to 2016
$4.3M
NCATS NIH HHS KL2 TR000370NCATS NIH HHS UL1 TR000371NCATS NIH HHS UL1 TR003167NINDS NIH HHS P50 NS044227
6 · The paper itself

Abstract

objectiveThe aim of the study was to investigate whether the elimination of trial admissions and the initiation of documentation requirements, via the 2010 Centers for Medicare and Medicaid Services Inpatient Rehabilitation Facility Prospective Payment System Rule, limited inpatient rehabilitation facility access while increasing skilled nursing facility utilization compared with home discharge in ischemic stroke patients.

designThis is a retrospective observational study using Get with the Guidelines - Stroke hospital data between January 1, 2008 and December 31, 2015 (N = 1,643,553).

resultsBetween January 1, 2008 and December 31, 2009, 54.1% of patients went home, 25.4% to inpatient rehabilitation facility and 20.5% to skilled nursing facility. Between January 1, 2010 and December 31, 2015, there was a 1.4% absolute increase in home discharge, a 1.1% inpatient rehabilitation facility decline and a 0.3% skilled nursing facility decline.Within the 1.1% absolute decline in inpatient rehabilitation facility discharge, the adjusted odds of inpatient rehabilitation facility versus home discharge decreased 12% after 2010 Rule (adjusted odds ratio = 0.88, 95% confidence interval = 0.87-0.89, P < 0.0001). There was no statistically significant change in skilled nursing facility versus home discharge.Lower adjusted odds of inpatient rehabilitation facility discharge versus home discharge were identical across age groups and were present in all geographic regions.

conclusionsIn populations with ischemic stroke, the Centers for Medicare and Medicaid Services 2010 Inpatient Rehabilitation Facility Prospective Payment System Rule was associated with a 1.1% absolute decrease in inpatient rehabilitation facility discharge, with a concomitant increase in home discharge rather than to skilled nursing facility.

Indexed as

Health Care ReformAdultAgedFemaleHumansIschemic StrokeMaleMedicareMiddle AgedPatient Acceptance of Health CareRehabilitation CentersRetrospective StudiesSkilled Nursing FacilitiesSubacute CareUnited StatesYoung Adult

Identifiers

PMID33002913
PMCPMC8004542
OpenAlexW3089655334

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.