Rehabilitation for Post-Acute Care

Topic Suggestion

1. What is the decision or change you are facing or struggling with where a summary of the evidence would be helpful?

We are interested in comparative patient outcomes (e.g. improvement in function and quality of life) between inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs) and other post-acute care (PAC) settings (e.g. home health or long-term care hospitals) for common PAC diagnoses including stroke, brain injury, spinal cord injury, and complex medical status.

2. Why are you struggling with this issue?

Patients discharged from acute care settings are faced with several options for post-acute care. The care that patients will receive in each PAC setting will vary drastically and have an enormous impact on their overall outcomes (including factors such as mobility, self-care, length of stay, etc.). As the number of patients being discharged to skilled nursing facilities is increasing, it is critical that we understand the outcomes that patients may have if admitted to a skilled nursing facility compared to an inpatient rehabilitation facility or other PAC setting. Further, as health care reform legislation and Medicare seeks a unified payment for PAC, the need for a systematic review of research examining service delivery and outcomes is critical.

3. What do you want to see changed? How will you know that your issue is improving or has been addressed?

There needs to be improved guidance to help physicians understand which PAC setting is most optimal for each individual patient, and what other factors (besides PAC setting) mediate outcomes.

4. When do you need the evidence report?

5. What will you do with the evidence report?

An evidence report could be disseminated to health care providers, policy makers, and health care agencies (e.g. MedPAC) to inform important decisions regarding health care and payment reform in the PAC setting.

Supporting Document

Title or short description: Comparative patient outcomes in IRFs vs. SNFs vs. other PAC settings

(Optional) About You

What is your role or perspective?

Medical Specialty Society

If you are you making a suggestion on behalf of an organization, please state the name of the organization:

American Academy of Physical Medicine and Rehabilitation

May we contact you if we have questions about your nomination?

Yes

Title: Manager, Health Policy and State Legislative Affairs