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JAMA Study Findings: IRFs Best Setting for Patients Recovering from Stroke

A recent study conducted by the University of Texas Medical Branch adds to the research indicating that inpatient rehabilitation facilities (IRFs) are the best possible post-acute care option for patients who have suffered a stroke.

IRFs Best Setting for Patients Recovering from Stroke

The study, published in the December 5 issue of JAMA, examined the records of 99,185 patients from 3,405 hospitals across the country who had received post-acute care after a stroke. The findings showed that inpatient rehabilitation in IRFs for patients with stroke was associated with substantially improved physical mobility and self-care function compared with rehabilitation in skilled nursing facilities (SNFs).

The study’s conclusions – recommending IRFs as the best setting for stroke rehabilitation – mirror those of the “Guidelines for Adult Stroke Rehabilitation and Recovery” presented in 2016 by the American Heart Association/American Stroke Association.

Stroke impacts approximately 800,000 people annually in the U.S. More than two-thirds of these individuals receive rehabilitation services after hospitalization in any of a number of post-acute care settings. Since post-acute care is the largest contributor to geographic variation in Medicare costs, the Texas Medical Branch study sought to determine the most effective type of post-acute care setting for Medicare beneficiaries who suffered from stroke.

The study looked at stroke patients between the years 2013-2014 and found that the IRF patients made significantly higher gains in mobility and self-care. The mobility score for IRFs measured the level of help needed for transfer to bed, chair, or wheelchair; transfer to toilet, transfer tub or shower; locomotion via walking or a wheelchair; and locomotion on stairs. Self-care scores in IRFs measured the level of help needed for eating, grooming, bathing, dressing upper body, dressing lower body and toileting.

To view the JAMA study, click here.


JAMA Netw Open. 2019;2(12):e1916646. doi:10.1001/jamanetworkopen.2019.16646, December 2019

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