Poster 501 Comparing WeeFIM Outcomes in Children with Developmental Disabilities to Children without Developmental Disabilities

Poster 501 Comparing WeeFIM Outcomes in Children with Developmental Disabilities to Children without Developmental Disabilities

Abstracts / PM R 8 (2016) S151-S332 Design: An educational exposition (Expo) was developed to increase medical student exposure and interest. 2015 mar...

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Abstracts / PM R 8 (2016) S151-S332 Design: An educational exposition (Expo) was developed to increase medical student exposure and interest. 2015 marked the fifth anniversary of this annual event. This study is designed to evaluate the impact of the Expo on medical students. Setting: Medical school affiliated with a major urban medical center. Participants: First, second, and third year medical students. Interventions: The Expo is an innovative approach that uses a rotating station format to increase awareness among the medical students regarding the various aspects of PM&R. Students are divided into 5 small groups that rotate between 15-minute stations in which residents, fellows, and attending physicians give presentations and answer questions about various aspects of PM&R: Traumatic Brain Injury & Spinal Cord Injury; Sports Medicine; Pain Management; Electrodiagnostics & Spasticity; and Amputee & Pediatric Rehabilitation. Main Outcome Measures: Pre-testing and post-testing of the students, using an Institutional Review Board (IRB)-approved survey, allowed for objective measurement of the effect of the Expo on student exposure and knowledge. National PM&R residency match data of United States (U.S.) seniors was also evaluated and compared to the match data of seniors at our school. Results: The survey results confirm that the Expo greatly increased student knowledge of and interest in PM&R. Historical match data demonstrates that each year between 2005 and 2011 only 0.005% of seniors at our medical school matched into PM&R, while the national average for all U.S. seniors in the match was 0.01%. From 20122015, after the start of the Expo, the average rate at our school rose to 1.5%, surpassing the national average which remained at 0.01%. Conclusions: This demonstrates that using a format of small groups rotating between stations covering the breadth of PM&R is an effective way to give medical students a comprehensive exposure and increase insight and interest in the field. Level of Evidence: Level V Poster 501 Comparing WeeFIM Outcomes in Children with Developmental Disabilities to Children without Developmental Disabilities Mary Schmidt, DO (UPMC, Pittsburgh, PA, United States), Amy J. Houtrow, MD, PhD, MPH Disclosures: Mary Schmidt: I Have No Relevant Financial Relationships To Disclose Objective: To determine how inpatient rehabilitation (IPR) WeeFIM outcomes differ between children with developmental disabilities and children without developmental disabilities. Design: Secondary data analysis of the Uniform Data Systems (UDS) IPR WeeFIM data from 2004-2014. Setting: 77 national inpatient pediatric rehabilitation programs. Participants: 36,418 children aged 3-18 years undergoing inpatient pediatric rehabilitation. Interventions: Not applicable. Main Outcome Measures: Length of stay (LOS), WeeFIM gain and WeeFIM efficiency. Results: 3232 children (8.9% of the sample) were classified with an impairment code for developmental disability. Compared to children with other types of impairments, children with developmental disabilities were more commonly admitted from home (30.3% compared to 12.3%), had public health insurance (56.8% compared to 44.3%) and were cared for in the Northeast (50.3% compared to 33.3%) and Midwest (29.1% compared to 22.8%) regions in freestanding pediatric rehabilitation hospitals (43.1% compared to 28.2%) (P<0.05 for all comparisons). The average age of children with developmental disabilities was one year younger than children with other impairment codes. On average, after controlling for sociodemographic and hospital characteristics, children with developmental disabilities spent 6.8 additional days in IPR, were admitted with lower admission WeeFIM

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scores by 6.4 points, had 10 points lower in WeeFIM gain, and had lower WeeFIM efficiency (0.84 compared to 2.1). Conclusions: This study is the first to describe the sociodemographic characteristics and inpatient rehabilitation outcomes of children with developmental disabilities. Children with developmental disabilities have worse rehabilitation outcomes compared to other children despite longer LOS. This highlights the need to pay special attention to this population during rehabilitation planning and anticipate intrinsic barriers to rehabilitation success. Level of Evidence: Level II Poster 502 Cost Analysis of Patients with Knee and Back Pain: Potential Implications for Care for patients Ratnakar P. Veeramachaneni, MD (Montefiore Medical Center/Albert Einstein College of Medicine, Brooklyn, NY, United States), Matthew N. Bartels, MD, MPH, Se Won Lee, MD, Karen Morice, MD Disclosures: Ratnakar Veeramachaneni: Access to commercial database - APOS US Management, Inc. Objective: Evaluate overall cost differences for provision of care based on claims data from insurers for patients with back and knee pain as a primary diagnosis. Design: Retrospective epidemiological cohort study of claims data from MarktscanÒ Commercial and Medicare Claims Databases. Search criteria: 1) Two claims in 1 year of knee or back pain between 1/1/ 2013 - 7/31/2014; 2) costs assessed in 2013 after the second diagnosis. Patients divided into cohorts 40-64 years and 65-75 years. Setting: Commercial Insurance Claims Database. Participants: Claims data from participating Insurance companies. Interventions: Not applicable. Main Outcome Measures: Costs reported in mean dollars (+/- standard deviation). Patients were grouped as knee pain positive (KP+) or knee pain free (KP-) and back pain positive (BP+) and back pain free (BP-). Results: Patients aged 40-64 years: KP+ (N¼142,633) costs were $24,359.46 ($37,621.62), KP- (N¼35,624,200) costs were $7,279.90 ($22,199.48). BP+ (N¼2,473,851) costs were $14,804.12 ($33,468.91), BP- (N¼32,363,425) costs were $5,977.89 ($19,591.14). Patients aged 65-75 years: KP+ (N¼48,369) costs were $28,079.17 ($41,257.84), KP(N¼4,938,575) costs were $12,225.68 ($33,284.91). BP+ (N¼389,456) costs were $21,399.99 ($45,658.91), BP- (N¼4,513,427) costs were $10,358.55 ($30,067.53). P  .01 for all values. Evaluation of the population shows KP+ 0.4% prevalence in 40-64 year-olds, 1.0% prevalence in 65-75 year-olds. Evaluation of the population shows BP+ 7.1% prevalence in 40-64 year-olds, 7.9% prevalence in 65-75 year-olds. Costs for KP+ were lower in both age groups ($24,359.46/$28,079.17) than for BP+ ($14,804.12/$21,399.99). Conclusions: Analysis of the claims data from 34,837,276 40-64 yearolds and 4,902,883 65-75 year-olds demonstrates significantly higher costs for care with patients with both KP+ and BP+ than age matched controls. There also are a higher number of individuals with BP+, but at a lower cost per case than KP+. A better understanding of the underlying health economics of both knee and back pain may influence allocation of treatment resources. Supported by an unrestricted grant from the Everest Foundation. Level of Evidence: Level IV Poster 503 Association Between Functional Assessment of Patients and Their Outcomes: A Systematic Review Thiru M. Annaswamy, MD, MA (Dallas VA Medical Center, Dallas, Texas, United States), Elliot J. Roth, MD, Amy J. Houtrow, MD, PhD, MPH, David Berbrayer, MD, BSC(MED), MCFPC, FRCPC, DABPM&R, FAAPM&R, Walter R. Frontera, MD, PhD, Allen Heinemann, PhD, ABPP (RP), FACRM, Leighton Chan, MD, MPH, Betsy Sandel, MD, Belinda Ireland, MD