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Final Report on Assessment Instruments for a Prospective Payment System
註釋These appendices accompany a report that evaluates alternative assessment tools for use in a prospective payment system (PPS) for inpatient rehabilitation facilities. They include samples of study forms and instructions; descriptions of measures; recruitment and participation letters; characteristics of participating facilities; sample study newsletters; and sampling protocols. The PPS was designed for use with the Functional Independence Measure. Policymakers hoped to substitute a new, more comprehensive, multipurpose assessment instrument, the Minimum Data Set-Post-Acute Care (MDS-PAC). This study compares the potential effects of this substitution. The MDS-PAC is a comprehensive data collection tool, with over 300 items, including sociodemographic information, pre-admission history, advance directives, cognitive and communication patterns, mood and behavior patterns, functional status, bladder/bowel management, diagnoses, medical complexities, pain status, oral/nutritional status, procedures/services, functional prognosis, and resources for discharge. To use the MDS-PAC in the new payment system, researchers needed a way to create a FIM-like motor score and a FIM-like cognitive score. A proposed translation was refined and evaluated. The goal of the report was to determine whether the planned substitution of the MDS-PAC for the FIM in the proposed inpatient rehabilitation hospital prospective payment system would adversely affect system performance, patients, or hospitals.