Efficacy of 7 Days per Week Inpatient Admissions and Rehabilitation Therapy

DiSotto-Monastero M, Chen X, Fisch S, Donaghy S, Gomez M. Efficacy of 7 days per week inpatient admissions and rehabilitation therapy.ObjectiveTo evaluate the efficacy of 7d/wk of inpatient admissions and rehabilitation therapy (7DART) in a rehabilitation hospital.DesignCross-sectional, retrospective electronic data review.SettingRehabilitation hospital.ParticipantsAdult patients who participated in the 7DART program and were admitted and discharged between February 2009 and January 2010 (n=1808), and adult patients who received 5d/wk of inpatient admissions and rehabilitation therapy (5DART), and were admitted and discharged between February 2008 and January 2009 (n=1692).InterventionsOccupational therapy and physiotherapy during the weekends (7DART only).Main Outcome MeasuresFIM rating change from admission to discharge, length of hospital stay, rehabilitation workload per patient, and discharge destination.ResultsThere were 3500 patients admitted with a mean age ± SD of 72.1±13.3 years and a male-to-female ratio of 1:1.9. Under 7DART conditions, there was a 6.9% increase in admissions (7DART=1808 vs 5DART=1692, P=.006), an 86% increase in weekend admissions (255 vs 137, P<.001), a 13.2% increase in rehabilitation workload per patient (40.7h vs 36h, P<.001), and a 5.4% decrease in rehabilitation hospital stay (19.3d vs 20.3d, P=.043). Similar FIM rating changes were obtained from admission to discharge under both conditions (18.2 for 7DART vs 18.7 for 5DART, P=.099). Both groups resulted in 94% of patients achieving their rehabilitation goals (7DART=94.1%, 5DART=94.5%; P=.967), and 88.6% of patients returning to their homes (7DART=88.1%, 5DART=89.2%; P=.334).ConclusionsDespite the fact that patients in both groups had similar functional outcomes and discharge destination, the 7DART rehabilitation model reduced length of hospital stay and increased rehabilitation workload, demonstrating increased efficiency and access to care by admitting more patients from acute care, rehabilitating them, and discharging them to the community in less time than the 5DART model.