Inpatient Rehabilitation Utilization for Medicare Beneficiaries With Multiple Sclerosis

Morley MA, Coots LA, Forgues AL, Gage BJ. Inpatient rehabilitation utilization for Medicare beneficiaries with multiple sclerosis.ObjectiveTo explore the use of inpatient rehabilitation facility services and levels of impairment for Medicare beneficiaries with multiple sclerosis (MS) by comparing differences in service utilization and clinical characteristics between Medicare beneficiaries with MS to the overall Medicare population.DesignMedicare beneficiaries with MS were identified using Medicare claims data. Claims and assessment data were analyzed to compare outcomes for beneficiaries with MS who used inpatient rehabilitation compared with a random sample of Medicare beneficiaries without MS.SettingInpatient rehabilitation facilities.ParticipantsMedicare beneficiaries with a diagnosis of MS who received inpatient rehabilitation during the 2007 calendar year (n=4669) and a random sample of Medicare beneficiaries without MS (n=14,397).InterventionsNot applicable.Main Outcome MeasuresChange in functional impairment levels between admission and discharge to inpatient rehabilitation and length of stay.ResultsThere were several differences in beneficiary characteristics between the 2 groups. Beneficiaries with MS had lower change in functional levels (−3.3 points on the FIM) and longer length of stay (0.4d).ConclusionsWhile beneficiaries with MS account for a small proportion of the Medicare population, the benefit is important to those who qualify for Medicare coverage. This study illustrates the differences between the subpopulation of beneficiaries with MS and other Medicare beneficiaries. The findings show that populations with MS had less functional improvement than other Medicare populations using the inpatient rehabilitation setting. Higher rates of depression within the MS Medicare population was a secondary finding that presents another important consideration for rehabilitation service needs for this group.