In this issue of THE JOURNAL, the randomized trial of early inpatient
rehabilitation after elective arthroplasty by Munin and colleagues1 provides information to improve the care of patients
undergoing joint replacement surgery. The authors conclude it is both safe
and effective to transfer patients to inpatient rehabilitation units as early
as 3 days following surgery, and also report lower overall costs for patients
in the "early transfer" group. In this study, all patients (except those who
were excluded or dropped out of the study) were transferred to rehabilitation
units; there was no patient group discharged home directly. The emphasis of
the study is clearly on the role of inpatient rehabilitation in the continuum
of care of joint replacement patients. The practice of inpatient rehabilitation
has become a common component of the care of many patients with a variety
of medical and surgical conditions requiring inpatient hospitalizations. The
key question is why have inpatient rehabilitation programs become such an
important part of health care during the past 10 years? The answer, in part,
may have originated from efforts to not only benefit patient care, but also
to improve facility reimbursement.
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