How appropriate is the use of rehabilitation facilities? Assessment by an evaluation tool based on the AEP protocol


Background. During the last few decades, an increasing attention has been drawn to public health expenditure and resource use. The increasing aging population has highlighted the need to deliver post-acute care and to assess its appropriateness. The ?PRUO rehab? (Protocollo di Revisione dell?Utilizzo dell?Ospedale riabilitativo) protocol was realized and validated to assess the appropriateness of use of rehabilitation units. The aims of this study were to test the validity of the PRUO-rehab tool and to analyse the causes for Inappropriate Hospital Stay (IPS) in rehabilitation units. Methods. The PRUO rehab tool was retrospectively applied to the medical records of 502 patients who stayed at least overnight in one of ten different rehabilitation units set in Northern Italy, during 2007. Results. The tool was valid and the inappropriate patient stay (IPS) score was 25.0%. Conclusion. Although reasonably low, the IPS indicates that the rehabilitation structures analysed could be used more efficiently.