Costs and Effectiveness of Stroke Rehabilitation: Measurement and Prediction

摘要

Addressing the need for information and methodologies relevant to the cost-benefits and cost-effectiveness of medical rehabilitation, this dissertation focuses on the measurement and prediction of health status and cost outcomes that are necessary for the characterization of cost-benefits effectiveness of stroke rehabilitation programs. Ninety-four hemiplegic stroke patients, consecutively admitted to a comprehensive rehabilitation hospital during 1981 were followed from admission to three months after discharge. Providers, patients and families were interviewed. Medical records and the hospital's program evaluation data systems were also examined. A quantitative scale of the family's ability to take care of the patient without payment--Family Help Available--was developed. Estimating 'cost' on the basis of charges for goods and services, inpatient rehabilitation charges exceeded all other charges measured. Rehospitalization charges after discharge from rehabilitation were 80-90 percent of post-discharge medical bills. Thirty percent of the sample was rehospitalized during the follow-up period. Functional status at admission, improvement prior to admission and patient age were primary predictors of functional status three months after discharge.