FIM Scores, FIM Efficiency, and Discharge Disposition Following Inpatient Stroke Rehabilitation


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The Functional Independence Measure™ (FIM) is a widely accepted scale used to measure the functional abilities of patients undergoing rehabilitation. Scores at the extremes of this scale correlate with discharge disposition, while mid-range scores are less well understood. This study evaluated the rate of FIM change with time (“efficiency”), admission and discharge FIM scores, and discharge disposition of 748 patients who underwent stroke inpatient rehabilitation. Patients with low scores at admission or discharge were likely to be discharged to a facility (63% and 78%, respectively), and those with high scores at admission or discharge almost always returned home (88% and 81%, respectively). Those with midrange scores at admission were more likely to return home (62%) than those with similar scores at discharge (33%). Greater FIM efficiency scores were associated with home discharge. Findings provide insight into discharge planning for stroke patients and indicate the need for more detailed evaluation of the midrange group.