Background and Objective. The purpose of this retrospective observational study was to examine the influence of severe obesity on length of stay (LOS), rehabilitation efficiency, and hospital costs post-acute rehabilitation in a population-based, tertiary care, publicly-funded regional rehabilitation center. Participants. 42 severely obese subjects (mean age 53 y; mean BMI 50.9 kg/m2) and 42 nonobese controls (mean age 59y; mean BMI 23.0 kg/m2) matched by sex and admitting diagnosis. Main Outcome Measures. Total LOS, rehab LOS, waiting for transfer LOS, Fuctional Independence Measure (FIM) efficiency, and hospital costs. Results. Compared to controls, severely obese subjects experienced longer total LOS (98.4 vs. 37.4 days; P = 0.03), rehabilitation LOS (55.8 vs. 37.4 days; P = 0.04), and waiting for transfer LOS (42.6 vs. 0 days; P = 0.006); increased hospital costs ($115,822 vs. $43,969; P = 0.03); and similar FIM efficiency (0.58 vs. 0.67; P = 0.27). Severe obesity was an independent predictor of total LOS (beta-coefficient 0.51; P = 0.03), rehab LOS (0.46; P = 0.02) but not FIM efficiency (-0.63; P = 0.06). Conclusion. Severe obesity adversely affects rehabilitation LOS and expenditures. Targeted interventions in severely obese individuals to optimize post-acute rehabilitation care delivery are needed.
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机译：背景和目标。这项回顾性观察研究的目的是检验在以人口为基础的三级护理，公共资助的区域康复中心中，严重肥胖对住院时间（LOS），康复效率和急性康复后医院费用的影响。参加者42例严重肥胖的受试者（平均年龄53岁;平均BMI 50.9千克/平方米）和42例非肥胖对照组（平均年龄59岁;平均BMI 23.0千克/平方米），按性别和准入诊断相匹配。主要观察指标。总服务水平，修复服务水平，等待转移服务水平，功能独立性度量（FIM）效率和医院成本。结果。与对照组相比，重度肥胖受试者的总LOS（98.4 vs. 37.4天; P = 0.03），康复LOS（55.8 vs. 37.4天; P = 0.04）和等待转移LOS的时间更长（42.6 vs. 0天; P = 0.006）;医院费用增加（$ 115,822比$ 43,969; P = 0.03）;和类似的FIM效率（0.58对0.67; P = 0.27）。严重肥胖是总LOS（β系数0.51; P = 0.03），康复LOS（0.46; P = 0.02），而非FIM效率（-0.63; P = 0.06）的独立预测因子。结论。严重肥胖会对康复服务水平和支出产生不利影响。需要针对严重肥胖者进行有针对性的干预，以优化急性后康复护理的提供。
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