Davide Antonio Di Pietro, Adriana Olivares, Laura Comini, Alessia Saverino, Stefania De Trane, Rachele Piras, Giuliana Vezzadini, Sharon Cammisuli, Stefano Corna, Giorgio Ferriero, Francesco Negrini, Laura Marcuccio, Chiara Ferretti, Antonio Nardone, Valeria Pingue, Christian Lunetta
{"title":"RCS-E可预测大型神经运动康复环境的预后和资源分配。","authors":"Davide Antonio Di Pietro, Adriana Olivares, Laura Comini, Alessia Saverino, Stefania De Trane, Rachele Piras, Giuliana Vezzadini, Sharon Cammisuli, Stefano Corna, Giorgio Ferriero, Francesco Negrini, Laura Marcuccio, Chiara Ferretti, Antonio Nardone, Valeria Pingue, Christian Lunetta","doi":"10.1016/j.apmr.2025.10.001","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To assess the reliability of the Rehabilitation Complexity Scale - Extended (RCS-E) as a measure of rehabilitation complexity. Secondary outcomes include identifying which baseline data, including the RCS-E, are most predictive of rehabilitation stay effectiveness and exploring its role as a predictor of reimbursement for hospital admissions.</p><p><strong>Design: </strong>A retrospective observational study. Demographic and clinical variables were collected, including Length of Stay (LoS), modified Rankin Scale, modified Barthel Index (mBI), RCS-E, and reimbursement of stay.</p><p><strong>Setting: </strong>Study on inpatients admitted to the neuromotor Rehabilitation Units of the 16 Istituti Clinici Scientifici Maugeri IRCCS (November 2023 and June 2024).</p><p><strong>Participants: </strong>Of 5870 hospitalizations, 4091 (mean age 71.8 ±13 years; 42.2% male) met the inclusion criteria. The pre-post analysis was performed on 3792 patients (mean age 71.8 ±12.8 years; 41.6% male).</p><p><strong>Interventions: </strong>Rehabilitation program for neurological or orthopedic condition [median (1<sup>st</sup> - 3<sup>rd</sup> quartile) duration: 27 days (20-41)] MAIN OUTCOMES AND MEASURES: RCS-E scores on admission were categorised as follows: <8 (low complexity); 8-10 (medium complexity); >10 (high complexity). For each patient, we calculated the mBI derived parameters: mBI Gain, rehabilitation efficiency, and rehabilitation effectiveness.</p><p><strong>Results: </strong>A significant moderate Spearman correlation was found between RCS-E score and mBI (rho=-0.53, p<0.0001), LoS (rho=0.41, p<0.0001) and premorbid mRS (rho=0.23, p<0.0001). Rehabilitation efficiency and effectiveness were significantly lower in the high complexity group. Both RCS-E and mBI at admission significantly correlated with total reimbursement (both p<0.0001, rho=0.48 and rho=-0.43, respectively). Regression models indicated a predictive effect of RCS-E at admission on mBI at discharge.</p><p><strong>Conclusions: </strong>This study demonstrates the reliability and utility of RCS-E in assessing neurological and orthopedic rehabilitation complexity, predicting outcomes, and informing funding models.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The RCS-E is Predictive of Outcomes and Resource Allocation in a Large Neuromotor Rehabilitation Setting.\",\"authors\":\"Davide Antonio Di Pietro, Adriana Olivares, Laura Comini, Alessia Saverino, Stefania De Trane, Rachele Piras, Giuliana Vezzadini, Sharon Cammisuli, Stefano Corna, Giorgio Ferriero, Francesco Negrini, Laura Marcuccio, Chiara Ferretti, Antonio Nardone, Valeria Pingue, Christian Lunetta\",\"doi\":\"10.1016/j.apmr.2025.10.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To assess the reliability of the Rehabilitation Complexity Scale - Extended (RCS-E) as a measure of rehabilitation complexity. Secondary outcomes include identifying which baseline data, including the RCS-E, are most predictive of rehabilitation stay effectiveness and exploring its role as a predictor of reimbursement for hospital admissions.</p><p><strong>Design: </strong>A retrospective observational study. Demographic and clinical variables were collected, including Length of Stay (LoS), modified Rankin Scale, modified Barthel Index (mBI), RCS-E, and reimbursement of stay.</p><p><strong>Setting: </strong>Study on inpatients admitted to the neuromotor Rehabilitation Units of the 16 Istituti Clinici Scientifici Maugeri IRCCS (November 2023 and June 2024).</p><p><strong>Participants: </strong>Of 5870 hospitalizations, 4091 (mean age 71.8 ±13 years; 42.2% male) met the inclusion criteria. The pre-post analysis was performed on 3792 patients (mean age 71.8 ±12.8 years; 41.6% male).</p><p><strong>Interventions: </strong>Rehabilitation program for neurological or orthopedic condition [median (1<sup>st</sup> - 3<sup>rd</sup> quartile) duration: 27 days (20-41)] MAIN OUTCOMES AND MEASURES: RCS-E scores on admission were categorised as follows: <8 (low complexity); 8-10 (medium complexity); >10 (high complexity). For each patient, we calculated the mBI derived parameters: mBI Gain, rehabilitation efficiency, and rehabilitation effectiveness.</p><p><strong>Results: </strong>A significant moderate Spearman correlation was found between RCS-E score and mBI (rho=-0.53, p<0.0001), LoS (rho=0.41, p<0.0001) and premorbid mRS (rho=0.23, p<0.0001). Rehabilitation efficiency and effectiveness were significantly lower in the high complexity group. Both RCS-E and mBI at admission significantly correlated with total reimbursement (both p<0.0001, rho=0.48 and rho=-0.43, respectively). Regression models indicated a predictive effect of RCS-E at admission on mBI at discharge.</p><p><strong>Conclusions: </strong>This study demonstrates the reliability and utility of RCS-E in assessing neurological and orthopedic rehabilitation complexity, predicting outcomes, and informing funding models.</p>\",\"PeriodicalId\":8313,\"journal\":{\"name\":\"Archives of physical medicine and rehabilitation\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-10-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of physical medicine and rehabilitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.apmr.2025.10.001\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of physical medicine and rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.apmr.2025.10.001","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
The RCS-E is Predictive of Outcomes and Resource Allocation in a Large Neuromotor Rehabilitation Setting.
Objective: To assess the reliability of the Rehabilitation Complexity Scale - Extended (RCS-E) as a measure of rehabilitation complexity. Secondary outcomes include identifying which baseline data, including the RCS-E, are most predictive of rehabilitation stay effectiveness and exploring its role as a predictor of reimbursement for hospital admissions.
Design: A retrospective observational study. Demographic and clinical variables were collected, including Length of Stay (LoS), modified Rankin Scale, modified Barthel Index (mBI), RCS-E, and reimbursement of stay.
Setting: Study on inpatients admitted to the neuromotor Rehabilitation Units of the 16 Istituti Clinici Scientifici Maugeri IRCCS (November 2023 and June 2024).
Participants: Of 5870 hospitalizations, 4091 (mean age 71.8 ±13 years; 42.2% male) met the inclusion criteria. The pre-post analysis was performed on 3792 patients (mean age 71.8 ±12.8 years; 41.6% male).
Interventions: Rehabilitation program for neurological or orthopedic condition [median (1st - 3rd quartile) duration: 27 days (20-41)] MAIN OUTCOMES AND MEASURES: RCS-E scores on admission were categorised as follows: <8 (low complexity); 8-10 (medium complexity); >10 (high complexity). For each patient, we calculated the mBI derived parameters: mBI Gain, rehabilitation efficiency, and rehabilitation effectiveness.
Results: A significant moderate Spearman correlation was found between RCS-E score and mBI (rho=-0.53, p<0.0001), LoS (rho=0.41, p<0.0001) and premorbid mRS (rho=0.23, p<0.0001). Rehabilitation efficiency and effectiveness were significantly lower in the high complexity group. Both RCS-E and mBI at admission significantly correlated with total reimbursement (both p<0.0001, rho=0.48 and rho=-0.43, respectively). Regression models indicated a predictive effect of RCS-E at admission on mBI at discharge.
Conclusions: This study demonstrates the reliability and utility of RCS-E in assessing neurological and orthopedic rehabilitation complexity, predicting outcomes, and informing funding models.
期刊介绍：
The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities.
Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.
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