Does the presence of a specialized rehabilitation unit in a Veterans Affairs facility impact referral for rehabilitative care after a lower-extremity amputation?

Objective: To determine if the presence of specialized rehabilitation units (SRUs) within Veterans Affairs medical centers (VAMC) influences access to rehabilitation services.

Design: Retrospective cohort analysis.

Setting: Two types of VAMCs: those with and without SRUs.

Clinical factors associated with prescription of a prosthetic limb in elderly veterans.

Objectives: To determine how advanced age influences prosthetic prescription.

Design: Retrospective cohort analysis with theory-driven logistic regression models. A Post Amputation Quality-of-Life (PAQ) framework of outcomes was proposed and empirically tested.

Development of an integrated stroke outcomes database within Veterans Health Administration.

A fundamental goal of the Rehabilitation Outcomes Research Center of Excellence is to improve care and outcomes for veterans with rehabilitation needs. To achieve this goal, the Center's primary objective is increasing research capacity. The Integrated Stroke Outcomes Database is a collection of Veterans Health Administration (VHA) clinical and administrative data containing patient information on a cohort of stroke patients found in the Functional Status Outcomes Database (FSOD), National Patient Care Database (NPCD), and other VHA sources.

Why ethnic designation matters for stroke rehabilitation: comparing VA administrative data and clinical records.

Using existing administrative data to look at issues of ethnic disparities in rehabilitation-related outcomes may lead to misleading results. Problems can emerge from apparently small issues of reliability that are magnified by reclassification of ethnic designation and missing data in complete-subject analyses. We compared the reliability of ethnic assignment in Department of Veterans Affairs (VA) medical rehabilitation records for stroke patients with administrative records; reclassified the racial identifier from the administrative data in two ways; and examined the different sources of ethnic information in relation to severity, length-of-stay, disability assessment, and discharge disposition.

The hazards of stroke case selection using administrative data.

Background: Administrative data and ICD-9-CM diagnostic codes are frequently used in research efforts to evaluate risk adjusted patient outcomes, particularly mortality. Varying ICD-9-CM sampling algorithms have been used to identify stroke patients.

Objectives: This study evaluates the effects of different sampling strategies (one high sensitivity and one high specificity) on modeling stroke mortality as a performance indicator.