Multiple sclerosis rehabilitation outcomes: analysis of a national casemix data set from Australia

Objective

To examine the outcomes of inpatient rehabilitation for persons with multiple sclerosis (pwMS), using the Australian Rehabilitation Outcomes Centre (AROC) database.

Method

Deidentified data from the AROC database were analyzed for all rehabilitation admissions during 2003–2007, using four classes for functional level. The outcomes included Functional Independence Measure (FIM) scores and efficiency, hospital length of stay (LOS), and discharge destination.

Results

Of 1010 case episodes, 70% were women, admitted from home ( n = 851) and discharged into the community ( n = 890), and 97% ( n = 986) were in the higher three classes for functional level (classes 216, 217, and 218). Majority of the more disabled pwMS were treated in the public hospital system, with a longer LOS compared with private facilities ( P < 0.001). The FIM for classes 216–218 showed significant functional improvement during the admission ( P < 0.001), and those in higher classes showed less change (likely due to higher FIM admission scores). FIM efficiency was significantly higher in class 217 than other classes ( P < 0.001). The year-on-year trend was toward reducing hospital LOS and FIM efficiency, but these did not reach significance ( P = 0.107, P = 0.634).

Conclusion

The AROC data set is useful for describing rehabilitation outcomes for pwMS. However, additional information needs to be collected to evaluate nature of services provided and service implications.