Factors Influencing Decisions to Admit Patients to Veterans Affairs Specialized Rehabilitation Units After Lower-Extremity Amputation

Bates BE, Kwong PL, Kurichi JE, Bidelspach DE, Reker DM, Maislin G, Xie D, Stineman M. Factors influencing decisions to admit patients to Veterans Affairs specialized rehabilitation units after lower-extremity amputation.ObjectiveTo understand patient- and facility-level characteristics that influence decisions to admit veterans to a specialized rehabilitation unit (SRU) after a lower-extremity amputation.DesignDatabase study.SettingAll Veterans Affairs Medical Centers (VAMCs).ParticipantsVeterans with lower-extremity amputation discharged from VAMCs between October 1, 2002, and September 30, 2004.InterventionsNot applicable.Main Outcome MeasureAdmission to an SRU.ResultsThere were a total of 2922 veterans with lower-extremity amputations; 616 patients were admitted to an SRU, whereas 2306 received consultative rehabilitation services only. Patients admitted to an SRU waited longer to have their first rehabilitation assessment after surgery and had middle-range physical and cognitive disabilities. Patients who received consultative rehabilitation services only tended to have greater illness burden. They were more likely to have previous amputation complication, paralysis, or renal failure and either very severe or minimal physical and cognitive disabilities.ConclusionsThe selection of veterans with new lower-extremity amputations for admission to an SRU appears clinically reasonable and based on the likelihood of successful outcomes.