Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
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.
Ottenbacher KJ, Ostir GV, Smith PM, Illig SB, Linn RT, Granger CV. Length of Stay, Functional Outcome, and Mortality Following Medical Rehabilitation—Reply. JAMA. 2005;293(3):294-295. doi:10.1001/jama.293.3.295-a