Classification System for Inpatient Rehabilitation Patients: A Review andProposed Revisions to the Functional Independence Measure-Function Related Groups

摘要

This report presents the results of two technical advisory panels that reviewedthe adequacy of the Functional Independence Measure (FIM(sup sm)) as a measure of functional assessment for rehabilitation patients, the suitability of the Functional Independence Measure-Function Related Groups (FIM-FRGs) as a case-mix classification system and the feasibility of a propsective payment system based on (FIM-FRGs). The evaluations of these panels provided input for the replication of the FIM-FRGs using merged discharge data for a sample of rehabilitation facilities in 1994 obtained from the Uniform Data System for Medicinal Rehabilitation, Inc. and MEDPAR records from the Health Care Financing Administration. The report contains descriptions of the data, the data linkage methodology and the methodology and results of the grouping of the data using Classification and Regression Trees. A revised version of the FIM-FRGs was produced using admission FIM motor and cognitive subscale scores and age. The patient classification groups obtained represented a suitable replication of the original set of FIM-FRGs created by Dr. Margaret Stineman at the University of Pennsylvania Medical Center using 1990 FIM data.