State-of-the-Science on Postacute Rehabilitation: Setting a Research Agenda and Developing an Evidence Base for Practice and Public Policy. An Introduction

J Spinal Cord Med, 2007 · DOI: · Published: January 1, 2007

Simple Explanation

The symposium aimed to stimulate research on postacute care (PAC) rehabilitation to ensure health policy is based on solid evidence. A key focus was on improving the measurement of rehabilitation variables and developing methods for data collection and analysis. The symposium also addressed factors influencing access to postacute rehabilitation care and differences in service quality across PAC settings.

Study Duration

Not specified

Participants

More than 270 participants representing 166 organizations

Evidence Level

Not specified

Key Findings

1
Patient assessment data is collected in 3 of the 4 PAC settings, but item definitions and assessment periods differ.
2
There is a lack of clear evidence about which provider and treatment intensities are appropriate for specific patients.
3
Postacute rehabilitation care is fragmented into 4 ‘‘silos’’ based on provider type, creating disincentives for cost-effective service delivery.

Research Summary

Postacute rehabilitation care is a key component of the health care delivery system, yet we know little about the active ingredients of the rehabilitation process that produce the best outcomes. Well-designed research is needed to develop better measures for case-mix adjustment and outcomes of care. To advance rehabilitation effectiveness research and support the development of evidence-based policies, we must invest in developing new and improving existing measures of patient characteristics, treatment contents, and long-term outcomes.

Practical Implications

Improved Measurement

Develop validated measures of rehabilitation treatments and stronger cognitive and psychosocial outcome measures.

Equitable Access

Project the PAC needs of the population and understand how attitudes and cultural differences influence access.

Strategic Research Plan

Implement a strategic research plan with collaboration between payers, providers, research funders, and researchers.

Study Limitations

1
Lack of a common outcome assessment instrument across PAC settings.
2
Limited research on the impact of Medicare’s payment systems on PAC services.
3
The PPS itself is a primary obstacle to treatment innovation.

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