RESUMO
We describe the impact of war on Puerto Rican Veterans and family members. We used qualitative research methods to collect and analyze data. We interviewed 8 Veterans and 8 family members. We used the constant comparison method to review data to identify prominent themes. Two categories emerged: (1) Challenges associated with post-deployment family reintegration, and (2) A positive aftermath of war on the family. Overall, findings indicate that OEF/OIF Veterans and family members were not prepared for the changes they encounter post-deployment. Despite these challenges, some Veterans and family members strengthened their relationships and renewed their appreciation for one another.
Assuntos
Relações Familiares/etnologia , Guerra , Adulto , Campanha Afegã de 2001- , Feminino , Humanos , Guerra do Iraque 2003-2011 , Masculino , Porto Rico/etnologia , Pesquisa Qualitativa , Estados Unidos , Adulto JovemRESUMO
We investigated the determinants of inpatient rehabilitation costs in the Department of Veterans Affairs (VA) and examined the relationship between length of stay (LOS) and discharge costs using data from VA and community rehabilitation hospitals. We estimated regression models to identify patient characteristics associated with specialized inpatient rehabilitation costs. VA data included 3,535 patients discharged from 63 facilities in fiscal year 2001. We compared VA costs to community rehabilitation hospitals using a sample from the Uniform Data System for Medical Rehabilitation of 190,112 patients discharged in 1999 from 697 facilities. LOS was a strong predictor of cost for VA and non-VA hospitals. Functional status, measured by Functional Independence Measure (FIM) scores at admission, was statistically significant but added little explanatory value after controlling for LOS. Although FIM scores were associated with LOS, FIM scores accounted for little variance in cost after controlling for LOS. These results are most applicable to researchers conducting cost-effectiveness analyses.
Assuntos
Pessoas com Deficiência/reabilitação , Custos de Cuidados de Saúde , Custos Hospitalares/estatística & dados numéricos , Hospitais Comunitários/economia , Hospitais de Veteranos/economia , Centros de Reabilitação/economia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise Custo-Benefício , Feminino , Pesquisas sobre Atenção à Saúde , Hospitais Comunitários/estatística & dados numéricos , Hospitais de Veteranos/estatística & dados numéricos , Humanos , Tempo de Internação/economia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Centros de Reabilitação/classificação , Centros de Reabilitação/estatística & dados numéricos , Estados Unidos , United States Department of Veterans Affairs/economia , United States Department of Veterans Affairs/estatística & dados numéricosRESUMO
A fundamental goal of the Rehabilitation Outcomes Research Center of Excellence is to improve care and outcomes for veterans with rehabilitation needs. To achieve this goal, the Center's primary objective is increasing research capacity. The Integrated Stroke Outcomes Database is a collection of Veterans Health Administration (VHA) clinical and administrative data containing patient information on a cohort of stroke patients found in the Functional Status Outcomes Database (FSOD), National Patient Care Database (NPCD), and other VHA sources. Clinical and administrative data were abstracted from several VHA data sources and linked to form an integrated outcomes database. A primary cohort of stroke patients treated during fiscal year (FY) 2001 was identified from the FSOD. Matching data from the NPCD, Decision Support System, Health Economics Resource Center, and the National Veterans Survey were obtained, merged, and reported in brief. This integrated database structure will provide valuable support to enhance the VHA capacity to perform stroke rehabilitation research.
