RAS
Evaluation of Innovative Rehabilitation Alternatives and Critical Dimensions of
Rehabilitation Care
(Rehabilitation Alternatives Study)
Funded by: The Robert Wood Johnson Foundation
Project Period: 9/91 - 10/96
This study is an evaluation of outcomes and costs of rehabilitation care
provided in integrated HMO and integrated fee-for-service health systems.
The study involves extensive patient-level data collection and analysis of
outcomes and costs of care in 11 sites. Detailed clinical data were collected
on a sample of over 1055 stroke, hip fracture, and medical/surgical patients
receiving rehabilitation. Data include patient interviews at admission,
discharge, and 3, 6, 9, and 12 months after admission; provider-assessed
function during the rehabilitation stay; mental status, behavioral, and
depression testing; examination of the acute hospital and rehabilitation
chart; review of relevant radiological studies for stroke and hip fracture;
and staff questionnaires on intensity of service and care processed. With the
addition of Medicare claims data and HMO utilization reports, the study is
designed to determine the cost effectiveness of different approaches to
geriatric rehabilitation for different types of patients.
Key Staff: Kramer, Grigsby, Steiner
Journal Articles:
Kramer AM, Steiner JF, Kowalsky JC. "Rehabilitation and Subacute Care: A National Study Involving Six HMOs". HMO Magazine 35(1): 15-19, 1994.
Steiner JF, Kramer AM, Eilertsen TB, Kowalsky JC. "Development and Validation of a Clinical Prediction Rule for Prolonged Nursing Home Residence After Hip Fracture." Journal of the American Geriatrics Society 45: 1510-1514, 1997.
Kramer AM, Kowalsky JC, Lin MK, Grigsby J, Hughes R, Steiner JF. "Outcome and Utilization Differences for Stroke Patients in HMO and Fee-For-Service Systems." Journal of the American Geriatrics Society 48(7):726-34, 2000.
Coleman EA, Kramer AM, Kowalsky JC, Eckhoff DG, Lin MK, Hester E, Morganstern N, Steiner JF. "Outcomes and Utilization for Acute Hip Fracture in Managed Care and Fee-For-Service Settings." Effective Clinical Practice 3(5): 229-239, 2000.
Johnson MF, Kramer AM, Lin MK, Kowalsky JC, Steiner JF. "Outcomes of Older Persons Receiving Rehabilitation for Medical and Surgical Conditions Compared with Hip Fracture and Stroke." Journal of the American Geriatrics Society 48: 1389-1397, 2000.
Grigsby J, Kaye K, Eilertsen TB, Kramer AM. "The Behavioral Dyscontrol Scale and Functional Status Among Elderly Medical and Surgical Rehabilitation Patients." Journal of Clinical Geropsychology 6(4): 259-268, 2000.
Grigsby J, Kaye K, Kowalsky JC, Kramer AM. "Association of Behavioral Self-Regulation with Concurrent Functional Capacity Among Stroke Rehabilitation Patients." Journal of Clinical Geropsychology 8(1):25-33, 2002.
Grigsby J, Kaye K, Kowalsky JC, Kramer AM. "Relationship between functional status and the capacity to regulate behavior among elderly persons following hip fracture." Rehabilitation Psychology 47:291-307, 2002.
Research Monographs:
Kramer AM, Steiner JF, Grigsby J, Kowalsky JC, Morgenstern N, Schlenker RE, Shaughnessy PW. Evaluation of Innovative Rehabilitation Alternatives and Critical Dimensions of Care: Research Design. Center for Health Services Research, Denver, Colorado. 1992.
Kramer AM, Steiner JF, Kowalsky JC, Mays G, Morgenstern N, Grigsby J. Descriptive Profiles of Rehabilitation Care. Center for Health Services Research, Denver, Colorado. December 1993.
Kramer AM, Kowalsky JC, Steiner JF, Hemming E, Eilertsen TB, Patel K, Gallegos L. Summary Report of Geriatric Rehabilitation Provided at Cedars-Sinai Medical Center, Eddy Cohoes Rehabilitation Center, LDS Hospital, St. Mary Medical Center, Kaiser Permanente, Fallon Clinic, Group Health Cooperative, Group Health Inc., Sierra Health services Inc, and FHP Health Care. Center for Health Services Research, Denver, Colorado. September 1995.
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