TY - JOUR
T1 - The structure and structural effects of VA rehabilitation bedservice care for stroke
AU - Reker, Dean M.
AU - Hoenig, Helen
AU - Zolkewitz, Michael A.
AU - Sloane, Richard
AU - Horner, Ronnie D.
AU - Hamilton, Byron B.
AU - Duncan, Pamela W.
PY - 2000
Y1 - 2000
N2 - The purpose of this study was to: 1) examine the variation in organizational structure within rehabilitation bed-service units (RBU) in the Veterans Health Administration (VHA), and 2) evaluate the effects of RBU and parent hospital structure on stroke rehabilitation outcomes. Two VHA-wide surveys of acute and rehabilitation services for stroke were linked with 2 y of VHA rehabilitation outcomes for stroke patients. A random effects mixed model was used to adjust for patient level covariates, control for unique site effects, and test for facility level structural effects. After adjusting for patient covariates, four structural variables were associated with length of stay or patient functional gain. These results indicate that rehabilitation structure is important to rehabilitation outcome. The individual variables identified in this study, namely, diverse multidisciplinary staff, expert physician leadership, staff participation in team care, and richer rehabilitation equipment resources, may represent the distinct aspects of a successful, comprehensive rehabilitation unit.
AB - The purpose of this study was to: 1) examine the variation in organizational structure within rehabilitation bed-service units (RBU) in the Veterans Health Administration (VHA), and 2) evaluate the effects of RBU and parent hospital structure on stroke rehabilitation outcomes. Two VHA-wide surveys of acute and rehabilitation services for stroke were linked with 2 y of VHA rehabilitation outcomes for stroke patients. A random effects mixed model was used to adjust for patient level covariates, control for unique site effects, and test for facility level structural effects. After adjusting for patient covariates, four structural variables were associated with length of stay or patient functional gain. These results indicate that rehabilitation structure is important to rehabilitation outcome. The individual variables identified in this study, namely, diverse multidisciplinary staff, expert physician leadership, staff participation in team care, and richer rehabilitation equipment resources, may represent the distinct aspects of a successful, comprehensive rehabilitation unit.
KW - Outcomes
KW - Rehabilitation
KW - Stroke
KW - Structure
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M3 - Article
C2 - 11028704
AN - SCOPUS:0034352281
SN - 0748-7711
VL - 37
SP - 483
EP - 491
JO - Journal of Rehabilitation Research and Development
JF - Journal of Rehabilitation Research and Development
IS - 4
ER -