Effect of Shortened Length of Stay on Functional and Educational Outcome after Pediatric Rehabilitation

Objective: The purpose of this study was to assess changes in the length of stay and its effect on effectiveness and return to school in an inpatient pediatric rehabilitation unit during a 5-yr period from fiscal year 1997 through 2001. Design: We reviewed prospectively collected data for a cohort of 321 children during fiscal years 1997-2001. Results: Length of stay was significantly shortened, with mean lengths of stay of 58.9, 43.5, 30.7, 40.9, and 24.0 days in years 1997 through 2001, respectively. Change in length of stay remained significantly decreased after adjusting for age, sex, admission diagnosis, admission severity, and type of health insurance. There was no difference in mean change in effectiveness measured by change in admission and discharge WeeFIM® ratings. There were significant differences across years in the educational placement of children at discharge, with a declining trend in the proportion of children discharged to classroom-based educational services. Conclusion: There was a reduction in inpatient length of stay during a 5-yr period for children in this pediatric rehabilitation setting. During this time, there was no change in the effectiveness of rehabilitation as measured by functional outcome. However, using return to a classroom setting as a marker of reintegration into routine activities, fewer children returned to a similar level of community participation.