Prescribed versus actual length of stay and inpatient neurorehabilitation outcome for brain dysfunctional patients.

ABSTRACT

OBJECTIVE: To determine (1) whether brain dysfunctional patients have better rehabilitation outcomes if they receive prescribed length of stay (LOS) versus less than prescribed and (2) if LOS and cognitive status relate to goal attainment. DESIGN: Prospective inception cohort study. STUDY SETTING: Medical center and a neurological institute. PARTICIPANTS: One hundred six patients with acute static brain lesions. MAIN OUTCOME MEASURES: Documentation of goal attainment at discharge and maintenance of goals 6 months after discharge. All subjects also received neuropsychological tests at admission and discharge. RESULTS: Patients who received prescribed LOS achieved their rehabilitation goals at discharge more frequently than patients who received less than prescribed LOS. There was, however, no difference between groups as to maintenance of rehabilitation goals 6 months after discharge. There was no relation between number of days spent in neurorehabilitation and number of goals achieved at discharge. Cognitive status at discharge was strongly related to achieving rehabilitation goals. CONCLUSION: Although LOS may not specifically relate to goal attainment in a heterogeneous group of brain dysfunctional patients, patients who receive the prescribed LOS and who show notable improvement in cognitive status tend to achieve rehabilitation goals, compared with patients who do not.