Functional independence, diagnostic groups, hospital stay, and modality of payment in three Croatian seaside inpatient rehabilitation centers

• Published in: Croatian medical journal 2010-12, Vol.51 (6), p.534-542
• Main Authors: Tomasović Mrčela, Nada, Massari, Dražen, Vlak, Tonko
• Format: Article
• Language: English
• Subjects: Activities of Daily Living - psychology; Administration; Adolescent; Adult; Aged; Confidence Intervals; Croatia; Cross-Sectional Studies; Diagnosis-Related Groups - statistics & numerical data; Female; Health Care Costs; Health Status; Hospitals; Humans; Inpatients - statistics & numerical data; Length of Stay - economics; Length of Stay - statistics & numerical data; Male; Management; Middle Aged; Multivariate Analysis; Odds Ratio; Payment; Public Health; Rehabilitation centers; Rheumatic Diseases - economics; Rheumatic Diseases - rehabilitation; Rheumatology - economics; Rheumatology - statistics & numerical data; Services; Statistics as Topic; Surveys; Surveys and Questionnaires; Treatment Outcome; Young Adult
• ISSN: 0353-9504; 1332-8166
• DOI: 10.3325/cmj.2010.51.534

To determine patients' functional independence, diagnostic groups, duration of hospital stay, and modality of payment of rehabilitation in major special hospitals for rheumatology and medical rehabilitation on the Croatian seaside. In a cross-sectional study conducted from October 2006 until January 2009, we surveyed 400 patients treated at 3 special hospitals for medical rehabilitation. Their functional independence was assessed by modified Barthel index and they self-evaluated their health using the first item from the 36-Item Short-Form Health Survey questionnaire. On admission, almost half of the patients (46%) were fully functionally independent, 33% were slightly dependent, while 21% were moderately or severely dependent. At the end of the hospitalization, significant predictors for the increase in Barthel index were longer hospital stay (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.06-1.22), diagnosis of post-procedural musculoskeletal disorders (OR, 4.84; 95% CI, 1.90-10.57), diagnosis of conditions following acute ischemic heart disease (OR, 9.71; 95% CI, 3.40-27.75), and lower Barthel index at admission (OR, 0.96; 95% CI, 0.94-0.97). Of the 97 patients with dorsopathy, 73 (75%) were fully functionally independent and 57 (59%) paid for the treatment either themselves or contributed substantially to the total cost. Assessment of patients' functional status is important for the organization of inpatient rehabilitation. Patients with dorsopathy could be targeted as a population for medical tourism in rehabilitation medicine in order to maximize the use of rehabilitation hospitals.