Objective: To assess the reliability of the Rehabilitation Complexity Scale - Extended (RCS-E) as a measure of rehabilitation complexity. Secondary outcomes include identifying which baseline data, including the RCS-E, are most predictive of rehabilitation stay effectiveness and exploring its role as a predictor of reimbursement for hospital admissions. Design: A retrospective observational study. Demographic and clinical variables were collected, including Length of Stay (LoS), modified Rankin Scale, modified Barthel Index (mBI), RCS-E, and reimbursement of stay. Setting: Study on inpatients admitted to the neuromotor Rehabilitation Units of the 16 Istituti Clinici Scientifici Maugeri IRCCS (November 2023 and June 2024). Participants: Of 5870 hospitalizations, 4091 (mean age 71.8 ±13 years; 42.2% male) met the inclusion criteria. The pre-post analysis was performed on 3792 patients (mean age 71.8 ±12.8 years; 41.6% male). Interventions: Rehabilitation program for neurological or orthopedic condition [median (1st - 3rd quartile) duration: 27 days (20-41)] MAIN OUTCOMES AND MEASURES: RCS-E scores on admission were categorised as follows: <8 (low complexity); 8-10 (medium complexity); >10 (high complexity). For each patient, we calculated the mBI derived parameters: mBI Gain, rehabilitation efficiency, and rehabilitation effectiveness. Results: A significant moderate Spearman correlation was found between RCS-E score and mBI (rho=-0.53, p<0.0001), LoS (rho=0.41, p<0.0001) and premorbid mRS (rho=0.23, p<0.0001). Rehabilitation efficiency and effectiveness were significantly lower in the high complexity group. Both RCS-E and mBI at admission significantly correlated with total reimbursement (both p<0.0001, rho=0.48 and rho=-0.43, respectively). Regression models indicated a predictive effect of RCS-E at admission on mBI at discharge. Conclusions: This study demonstrates the reliability and utility of RCS-E in assessing neurological and orthopedic rehabilitation complexity, predicting outcomes, and informing funding models.
The RCS-E is Predictive of Outcomes and Resource Allocation in a Large Neuromotor Rehabilitation Setting
Ferriero, Giorgio;Negrini, Francesco;
2025-01-01
Abstract
Objective: To assess the reliability of the Rehabilitation Complexity Scale - Extended (RCS-E) as a measure of rehabilitation complexity. Secondary outcomes include identifying which baseline data, including the RCS-E, are most predictive of rehabilitation stay effectiveness and exploring its role as a predictor of reimbursement for hospital admissions. Design: A retrospective observational study. Demographic and clinical variables were collected, including Length of Stay (LoS), modified Rankin Scale, modified Barthel Index (mBI), RCS-E, and reimbursement of stay. Setting: Study on inpatients admitted to the neuromotor Rehabilitation Units of the 16 Istituti Clinici Scientifici Maugeri IRCCS (November 2023 and June 2024). Participants: Of 5870 hospitalizations, 4091 (mean age 71.8 ±13 years; 42.2% male) met the inclusion criteria. The pre-post analysis was performed on 3792 patients (mean age 71.8 ±12.8 years; 41.6% male). Interventions: Rehabilitation program for neurological or orthopedic condition [median (1st - 3rd quartile) duration: 27 days (20-41)] MAIN OUTCOMES AND MEASURES: RCS-E scores on admission were categorised as follows: <8 (low complexity); 8-10 (medium complexity); >10 (high complexity). For each patient, we calculated the mBI derived parameters: mBI Gain, rehabilitation efficiency, and rehabilitation effectiveness. Results: A significant moderate Spearman correlation was found between RCS-E score and mBI (rho=-0.53, p<0.0001), LoS (rho=0.41, p<0.0001) and premorbid mRS (rho=0.23, p<0.0001). Rehabilitation efficiency and effectiveness were significantly lower in the high complexity group. Both RCS-E and mBI at admission significantly correlated with total reimbursement (both p<0.0001, rho=0.48 and rho=-0.43, respectively). Regression models indicated a predictive effect of RCS-E at admission on mBI at discharge. Conclusions: This study demonstrates the reliability and utility of RCS-E in assessing neurological and orthopedic rehabilitation complexity, predicting outcomes, and informing funding models.
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
