Inpatient treatment time across disciplines in spinal cord injury rehabilitation

Gale Whiteneck, Julie Gassaway, Marcel Dijkers, Deborah Backus, Susan Charlifue, David Chen, Flora Hammond, Ching Hui Hsieh, Randall J. Smout

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Background/objective: Length of stay (LOS) for rehabilitation treatment after spinal cord injury (SCI) has been documented extensively. However, there is almost no published research on the nature, extent, or intensity of the various treatments patients receive during their stay. This study aims at providing such information on a large sample of patients treated by specialty rehabilitation inpatient programs. Methods: Six hundred patients with traumatic SCI admitted to six rehabilitation centers were enrolled. Time spent on various therapeutic activities was documented by each rehabilitation clinician after each patient encounter. Patients were grouped by neurologic level and completeness of injury. Total time spent by each rehabilitation discipline over a patient's stay and total minutes of treatment per week were calculated. Ordinary least squares stepwise regression models were used to identify patient and injury characteristics associated with time spent in rehabilitation treatment overall and within each discipline. Results: Average LOS was 55 days (standard deviation 37), during which 180 (106) hours of treatment were received, or 24 (5) hours per week. Extensive variation was found in the amount of treatment received, between and within neurologic groups. Total hours of treatment provided throughout a patient's stay were primarily determined by LOS, which in turn was primarily predicted by medical acuity. Variation in minutes per week of treatment delivered by individual disciplines was predicted poorly by patient and injury characteristics. Conclusions: Variations between and within SCI rehabilitation patient groups in LOS, minutes of treatment per week overall, and for each rehabilitation discipline are large. Variation in treatment intensity was not well explained by patient and injury characteristics. In accordance with practice-based evidence methodology, the next step in the SCIRehab study will be to determine which treatment interventions are related with positive outcomes (at 1 year post injury), after controlling for patient and injury differences.

Original languageEnglish
Pages (from-to)133-148
Number of pages16
JournalJournal of Spinal Cord Medicine
Volume34
Issue number2
DOIs
StatePublished - Mar 2011

Fingerprint

Spinal Cord Injuries
Inpatients
Rehabilitation
Length of Stay
Wounds and Injuries
Therapeutics
Nervous System
Rehabilitation Centers
Evidence-Based Practice
Least-Squares Analysis

Keywords

  • Case management
  • Health services research
  • Occupational therapy
  • Paraplegia
  • Physical therapy
  • Practice-based evidence
  • Psychology
  • Recreation therapy
  • Rehabilitation
  • Rehabilitation nursing
  • Social work
  • Speech-language pathology
  • Spinal cord injuries
  • Tetraplegia

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Whiteneck, G., Gassaway, J., Dijkers, M., Backus, D., Charlifue, S., Chen, D., ... Smout, R. J. (2011). Inpatient treatment time across disciplines in spinal cord injury rehabilitation. Journal of Spinal Cord Medicine, 34(2), 133-148. https://doi.org/10.1179/107902611X12971826988011

Inpatient treatment time across disciplines in spinal cord injury rehabilitation. / Whiteneck, Gale; Gassaway, Julie; Dijkers, Marcel; Backus, Deborah; Charlifue, Susan; Chen, David; Hammond, Flora; Hsieh, Ching Hui; Smout, Randall J.

In: Journal of Spinal Cord Medicine, Vol. 34, No. 2, 03.2011, p. 133-148.

Research output: Contribution to journalArticle

Whiteneck, G, Gassaway, J, Dijkers, M, Backus, D, Charlifue, S, Chen, D, Hammond, F, Hsieh, CH & Smout, RJ 2011, 'Inpatient treatment time across disciplines in spinal cord injury rehabilitation', Journal of Spinal Cord Medicine, vol. 34, no. 2, pp. 133-148. https://doi.org/10.1179/107902611X12971826988011
Whiteneck, Gale ; Gassaway, Julie ; Dijkers, Marcel ; Backus, Deborah ; Charlifue, Susan ; Chen, David ; Hammond, Flora ; Hsieh, Ching Hui ; Smout, Randall J. / Inpatient treatment time across disciplines in spinal cord injury rehabilitation. In: Journal of Spinal Cord Medicine. 2011 ; Vol. 34, No. 2. pp. 133-148.
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