Guidry News Service recently visited with Dr. Timothy Reistetter, an associate professor in the Department of Occupational Therapy at the University of Texas Medical Branch at Galveston, who is the lead author on research which found that rehabilitation outcomes for people who have had a stroke vary greatly depending on where they live in the United States. Listen (14:39)
The study was recently published in the journal Archives of Physical Medicine and Rehabilitation.
“Regional variations are a pretty common and popular issue right now in health care reform,” Dr. Reistetter said, noting that May is National Stroke Awareness Month.
The researchers studied Centers for Medicare and Medicaid Services records from 143,036 patients discharged from inpatient rehabilitation during 2006 and 2007. Research focused on length of stay, functional status (discharge motor and cognitive status, overall functional change) and the percentage of patients discharged to the community.
“We’re interested in the outcomes of care,” he said. “Not necessarily costs but, if in fact, there are regional factors that contribute to care utilization, it’s important for us to understand how those contribute to the actual outcomes that people have after they’ve had a stroke and they go through rehabilitation.”
Dr. Reistetter said that there is variation nationally in the availability of inpatient rehabilitation facilities. The four states with the highest number of facilities are Texas, California, Pennsylvania and New York, while Wyoming, West Virginia, Vermont and Delaware each has less.
“Depending on where you are in the country, there’s about a 20 percent difference in your likelihood, or rate, to return back to the community after rehabilitation,” he said.
The study’s co-authors are Kenneth J. Ottenbacher, Amol M. Karmarkar and James E. Graham of UTMB’s Division of Rehabilitation Sciences; Karl Eschbach, Jean Freeman and Yong-Fang Kuo of UTMB’s Sealy Center on Aging and Division of Geriatrics, Department of Internal Medicine; and Dr. Carl V. Granger, Uniform Data System for Medical Rehabilitation, Buffalo, NY.
“We have a pretty big group of health services researchers here at UTMB,” Dr. Reistetter said. “I’ve had the good fortune to be mentored by some rather prominent researchers.”
Funding for the study was provided by the National Institute of Child Health and Human Development, National Institutes of Health; the Institute for Translational Sciences at the University of Texas Medical Branch with support in part by a National Institutes of
Health Clinical and Translational Science Award; the Agency for Healthcare Research and Quality; and the National Institutes of Health.
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