Inpatient Rehabilitation Facility Ownership Type Yields Mixed Performances on Quality Measures.
Jessica Edelstein, Chih-Ying Li, Jay Meythaler and 2 others
PMID 37907161WHAT IT FOUND
Ownership type was linked to mixed facility-level quality scores.
Nonprofit IRFs had lower potentially preventable readmissions, while for-profit IRFs had higher facility-level function scores and discharge to community. It does not show either type delivers better care.
Key findings
01Nonprofit IRFs had less potentially preventable hospital readmissions 30 days after discharge from an IRF and potentially preventable hospital readmissions during the IRF stay compared to for-profit IRFs.
02For-profit IRFs had higher percentages for function assessed, expected self-care, expected mobility, and greater mean changes in self-care and mobility.
03Nonprofit IRFs had significantly lower spending per Medicare beneficiary than for-profit IRFs.
STILL TO COME
How it was doneWhat they found
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What it does not show
The analysis used facility-level public data, not patient-level records, so it could not show how individual patients performed. The authors state the functional score differences were often small and may not be clinically relevant. Facility-level thresholds for clinically meaningful differences have not been defined. Different quality measures apply to different populations, so one facility-level result does not generalise to all patients or measures. Government-owned facilities were grouped with nonprofit facilities based on tax filing status. Facilities without quality reporting data or ownership data were excluded, which could bias results. Some facility characteristics not captured may have affected the models.
The easy way to misread this
Do not conclude that for-profit IRFs provide better care because their functional quality scores were higher. These are facility-level averages, the differences were often small, and the study did not analyse patient-level outcomes.