The presence of new or worsening bedsores is an effective indicator of the quality of care for rehab patients, suggests a study from the University of Buffalo (UB) and published in Archives of Physical Medicine and Rehabilitation.
This is reportedly the first study to examine whether this metric is, in fact, associated with outcome of care in inpatient rehabilitation settings. New or worsened bedsores is a quality metric instituted as part of the Patient Protection and Affordable Care Act (ACA). The ACA requires that medical institutions be evaluated on their quality of care, notes a media release from the University of Buffalo.
Margaret DiVita, who conducted the research as a doctoral student in epidemiology at UB, is now an associate professor at SUNY Cortland. Using data from the Uniform Data System for Medical Rehabilitation, she examined the records for nearly 500,000 Medicare patients discharged between January 2013 and September 2014—after this mandated measure of quality was implemented.
“We looked at how good a proxy measure of quality the new or worsened pressure ulcer measure was, in particular to see if it was associated with poorer outcomes for rehabilitation patients. We found that it was indeed associated with lower quality outcomes: less gain in function during treatment, and lower likelihood of leaving rehab to go to a community setting,” says Jo Freudenheim, the paper’s senior author and chair of the Department of Epidemiology and Environmental Health in the UB School of Public Health and Health Professions.
While outcomes were poorer for those with new or worsened pressure ulcers, more than half of these patients were able to be discharged to a community setting, the release continues.
“A pressure injury prior to admission or greater likelihood of developing worse pressure injury are not appropriate grounds for denial of access to inpatient rehabilitation care,” the researchers write.
Compared to the control group, patients with a new or worsened bedsore tended to have a lower change score on the Functional Independence Measure (FIM), a basic indicator of patient disability, and to have, on average, longer rehabilitation stay. In this study, about 1% of patients experienced new or worsened bedsores during their rehabilitation stay.
[Source(s): University of Buffalo, Newswise]