OtherAmerican journal of physical medicine & rehabilitation2021

Understanding Variation in Postacute Care: Developing Rehabilitation Service Areas Through Geographic Mapping.

Timothy A Reistetter, Karl Eschbach, John Prochaska and 4 others

PMID 32858537

WHAT IT FOUND

Geographic service areas built from rehabilitation admissions captured slightly more variation in care than those built from acute hospital admissions.

This offers researchers a better map for studying where rehab services go, but provides no clinical guidance for treating patients.

Key findings

01Service areas based on rehabilitation admissions explained slightly more variation in postacute care use than those based on acute care admissions.

02The study defined 22 rehabilitation service areas in Texas using Medicare data to map geographic patterns of care.

STILL TO COME

How it was doneWhat they found

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What it does not show

The study focuses on Medicare beneficiaries aged 65 and older, so findings may not apply to younger patients or other insurance groups. The geographic boundaries are methodological tools for research and do not reflect clinical outcomes or treatment effectiveness. The analysis did not account for travel distance or time, only centroid distances. The study excluded outpatient services and did not adjust for patient-level differences influencing admission.

Declared interests

No conflicts of interest were reported by the authors.

The easy way to misread this

Do not interpret this as evidence that specific rehabilitation interventions are more effective in certain regions. The paper only describes how to map geographic service areas for research purposes; it does not measure patient outcomes or clinical results.

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The study

Participants
469,172 Texas beneficiaries, of which 183,437 had a postacute care admission
Certainty of evidence
Low

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    Cite

    Timothy A Reistetter, Karl Eschbach, John Prochaska, et al. Understanding Variation in Postacute Care: Developing Rehabilitation Service Areas Through Geographic Mapping. American journal of physical medicine & rehabilitation. 2021.

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