HealthDay News – Many interruptions in inpatient rehabilitation for stroke survivors and patients with brain and spinal cord injuries are avoidable, according to a study published online in the American Journal of Physical Medicine & Rehabilitation.

Addie Middleton, PhD, of the University of Texas Medical Branch in Galveston, and colleagues analyzed Medicare data on 79,537 patients undergoing inpatient rehabilitation for stroke (71,769), brain injury (7109) or spinal cord injury (659). All went to rehabilitation directly from the hospital. Rehabilitation interruptions occurred in 0.9% of stroke patients, 0.8% of brain injury patients, and 1.4% of spinal cord injury patients. In most cases, patients were transferred back to the hospital for treatment of complications.

The researchers found that, overall, about 11% to 12% of the rehabilitation interruptions may have been preventable, including 15% of those in stroke patients. Preventable causes of rehabilitation interruption included dehydration, heart failure, pneumonia, and urinary tract infections.

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“Reducing rates of program interruptions and short-stay transfers will not just improve patient experiences of care, they will likely also translate to lower Medicare spending per beneficiary,” the authors wrote. “Future research focused on identifying modifiable risk factors for these outcomes will allow for targeted preventative interventions.”


Middleton A, Graham JE, Krishnan S, Ottenbacher KJ. Program interruptions and short-stay transfers represent potential targets for inpatient rehabilitation care-improvement efforts. Am J Phys Med Rehabil. 2016 Sept 26. doi:10.1097/PHM.0000000000000629 [Epub ahead of print].