A Characterization of Cancer Patients in Inpatient Rehabilitation Facilities: A Retrospective Cohort Study

Abstract Objective To identify the types of cancer patients admitted to inpatient medical rehabilitation and to describe their rehabilitation outcomes. Design Retrospective cohort study; Setting U.S. inpatient rehabilitation facilities (IRFs) Participants Adult patients diagnosed with malignant cancer for a cancer related impairment admitted to an IRF between October 2010 and September 2012 were identified from the Uniform Data System for Medical Rehabilitation (UDSMR) database (n = 27,952). Interventions none Main Outcome Measure(s) Demographic, medical and rehabilitation characteristics for patients with various cancer tumor types were summarized using data collected from the Inpatient Rehabilitation Patient Assessment Instrument (IRF-PAI). Rehabilitation outcomes included the percentage of patients discharged to community and acute care settings and functional change from admission to discharge. Functional status was measured using the FIM® instrument. Results Cancer patients constituted about 2.4% of the total IRF patient population. Cancer types included brain and nervous system (52.9%), digestive (12.0%), bone and joint (8.7%), blood and lymphatic (7.6%), respiratory (7.1%) and other (11.7%). Overall, 72% were discharged to a community setting and 16.5% were discharged back to acute care. Patients with blood and lymphatic cancers had the highest frequency of discharge back to acute care (28%). On average, all cancer patient groups made significant functional gain during their IRF stay (FIM total change: 23.5 ± 16.2). Conclusions In a database representing approximately 70% of all US patients in IRFs, we found that a variety of cancer types are admitted to inpatient rehabilitation. The majority of cancer patients admitted to IRFs were discharged to a community setting and on average, improved their function. Future research is warranted to understand the referral patterns of admission to post-acute care rehabilitation and to identify factors that are associated with rehabilitation benefit in order to inform the establishment of appropriate care protocols.