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Rehabilitation Practice and Science

Translated Title

截肢患者術後接受住院急性復健利用率的觀察性研究

Abstract

Objective: To examine rates of inpatient rehabilitation (IR) use in a nationwide amputee and determine factors associated with receiving rehabilitation services during acute admission. Methods: This research is a retrospective observational study. We sampled data from a nationally representative sample of 1,000,000 enrollees of the single-payer government-based National Health Insurance (NHI) program in Taiwan from 1996 to 2013. Claims data for rehabilitation during index admission after amputation were analyzed, and factors associated with IR use were identified. Multivariable logistic regression was performed with adjustment for clustering to identify which factors were independently associated with acute IR referral. Results: Among the 5,162 amputees enrolled in this study, the primary reasons for amputation were diabetes (47.3%), trauma (32.4%), and peripheral vascular disease (10.7%). A total of 748 (14.5%) amputees received rehabilitation services during admission. The proportion of patients receiving rehabilitation services was low if the patient was older (OR: 0.52), received amputation due to DM (OR: 0.4), received minor lower limb amputation (OR: 0.44), was discharged from the internal medicine ward (OR: 0.68), or was hospitalized in a veteran hospital (OR: 0.23). Gender and dialysis did not influence the utilization of rehabilitation services. Conclusions: This study showed that both clinical characteristics and facility factors appear to influence the receipt of IR after amputation, thus suggesting that care patterns are not standardized across the nation. Prosthesis training is not equal to amputation rehabilitation, and identification of factors influencing the receipt of acute IR may help overcome barriers for the service and enhance the quality of healthcare.

Language

English

First Page

67

Last Page

77

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