Postacute Rehabilitation Research and Policy Recommendations

Clohan DB, Durkin EM, Hammel J, Murray P, Whyte J, Dijkers M, Gans BM, Graves DE, Heinemann AW, Worsowicz G. Postacute rehabilitation research and policy recommendations.This article summarizes the research and health policy recommendations developed by participants at the symposium “State-of-the-Science on Post-Acute Rehabilitation: Setting a Research Agenda and Developing an Evidence Base for Practice and Public Policy,” held in February 2007. A diverse group of participants represented federal government agencies, private insurers, professional organizations, providers of rehabilitation services, patients and their advocates, and health researchers. During roundtable discussions and theme-specific break-out sessions, participants were asked to consider 5 major topics regarding postacute rehabilitation care: (1) the extent of our knowledge, (2) the limitations of our knowledge, (3) the barriers that limit research, (4) research priorities to reduce these obstacles and assemble needed evidence, and (5) the major policy implications. Several key themes emerged: the need for improved measures, particularly of case-mix factors and treatment ingredients; the need for a more uniform and coherent system of postacute rehabilitation care to facilitate gathering of common data; the need to attend to underutilization as well as overutilization of rehabilitation services; the need for cooperation among payers, providers, and researchers to advance a rehabilitation effectiveness research agenda; and the desire to develop payment policies that are based on research evidence.