A regional study
Through funds allocated by the Italian Ministry of Health, in 2014 the Department of Rehabilitation of the University Hospital of Parma directed by Dr. Rodolfo Brianti launched a project entitled “Appropriateness of inpatient rehabilitation hospitalization: impact of an alternative coding system on excessively inappropriateness and on cost in the region”.
The aim was to improve the current management of the healthcare system in the Emilia Romagna region and reduce the excessive use of intensive rehabilitation wards in recent years.
Assessment scales and appropriateness criteria
The main objective of the study was to validate in Italian the Rehabilitation Complexity Scale Extended, for the assessment of the patient’s clinical complexity, to be used in association with the Barthel Index modified and the Cumulative Illness Rating Scale.
In addition, the appropriateness criteria for admission to intensive rehabilitation in orthopaedics, neurology and cardiology were investigated, based on EBM and clinician practice, using the Delphi method applied to a National Panel of rehabilitation experts (you can read the specific article here).
In order to get to the application of the rating scales, several activities have previously been carried out, such as training courses for doctors for the correct use of the assessment scales and the already mentioned national Delphi Panel with 16 experts.
A tailored database to collect the information
Once a consensus was reached on the appropriateness criteria and doctors were trained for a correct clinical assessment, MBE intervened as Data Manager for the creation of a database for the Electronic Case Report Form, in collaboration with the Project Manager Dr Francesca Rodà, PhD.
Starting with a test model, the database was then improved and customised in a second final version, based on the needs reported by clinicians during its use and allowing for the correct collection of information.
After more than six months, data from almost one thousand patients from seven different hospitals in the Emilia Romagna region were analysed. The scores assigned for each assessment scale under study were illustrated according to age characteristics and distinguished by nosological category.
The study paved the way for further in-depth work on the best appropriateness of rehabilitation hospitalisation, to increase the quality of health services and reduce unnecessary expense. Have a look at our next post on this topic!
