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January 19, 2005

Length of Stay, Functional Outcome, and Mortality Following Medical Rehabilitation—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;293(3):294-295. doi:10.1001/jama.293.3.295-a

In Reply: In response to Dr Duncan and colleagues, we wish to make 3 points regarding use of the FIM efficiency index. First, efficiency is a standard outcome measure that has been reported by the Uniform Data System for Medical Rehabilitation (UDSMR) since the 1980s. It has been used as a benchmark in annual UDSMR reports1 and is widely reported by researchers in medical rehabilitation. Second, we understand the deterministic inverse relationship between increased efficiency and decreased LOS. FIM efficiency is a convenient way of looking at the relationships between the gain in FIM points and LOS. Decreasing LOS from year to year coupled with either no change or an increase in FIM gain between admission and discharge results in increased FIM efficiency. Third, we found the same relationship using gain in FIM points (averaged over 7 days) but did not report this, since it was redundant with FIM efficiency.

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