The purpose of this study was to examine the relationships between severity of disability and factors such as rehabilitation fees, length of stay and efficiency for hospitalized stroke patients. One hundred and seven first-time stroke patients were studied consecutively for this study. They were recruited from a rehabilitation ward in a university medical center during 1997. Functional ability was evaluated using the Functional Independence Measure (FIM) instrument on admission and discharge. Stroke patients who presented with similar degrees of disability were put together using the admission FIM score (FIM Function-Related Groups, FIM-FRGs) for further analysis. Twenty-eight (26.2%) patients examined were categorized as severely disabled (scored 18-36), 48 (44.8%) moderately disabled (scored 37-72) and 31 (29.0%) mildly disabled (scored 73-126). The average expense on rehabilitation fees, for the average rehabilitation length of stay (LOSR) of 34.7 +/- 16.7 days, was NT$ 27,645 +/- 13,812. The FIM score improved from 56.8 +/- 24.2 on admission to 76.6 +/- 26.2 at discharge, with a rehabilitation efficiency index (EIR) of 0.7 +/- 0.7. Further analysis indicated that there were significant differences among the three disability groups on rehabilitation fees and LOSR while EIR was unaffected. The findings of this study suggest that FIM-FRGs can differentiate different rehabilitation needs in terms of rehabilitation fees and LOSR; therefore, a prospective case payment system based on FIM-FRGs is suggested for stroke rehabilitation reimbursement scheme in the future.

译文

这项研究的目的是检查残疾严重程度与住院卒中患者康复费用,住院时间和效率等因素之间的关系。这项研究连续研究了107名初次卒中患者。他们是在1997年从大学医疗中心的康复病房招募的。使用入院和出院的功能独立性评估(FIM)仪器对功能能力进行了评估。表现出类似残疾程度的中风患者使用入院FIM评分(FIM功能相关组,FIM-FRG)进行汇总以进行进一步分析。被检查的二十八(26.2%)位患者被分类为严重残疾(评分18-36),中度残疾(48-44.8%)(评分37-72)和轻度残疾(31-29.0%)(评分73-126)。平均康复时间(LOSR)为34.7 /-16.7天,平均康复费用为NT $ 27,645 /-13,812。 FIM评分从入院时的56.8 /-24.2提高到出院时的76.6 /-26.2,康复效率指数(EIR)为0.7 /-0.7。进一步的分析表明,在EIR不受影响的情况下,三个残疾人群体在康复费用和LOSR方面存在显着差异。这项研究的结果表明,FIM-FRG可以根据康复费用和LOSR区分不同的康复需求。因此,建议将来使用基于FIM-FRG的预期病例支付系统来进行中风康复报销计划。

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