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Inpatient Acute Rehabilitation Hospital Bills and Costs

Categories: Costs and Insurance

The Question

What costs are the most expensive during the acute inpatient rehabilitation stay for individuals with traumatic brain injuries?

Past Studies

Past Studies indicate the importance of affordable health care. Inpatient rehabilitation facility administrators need to be able to anticipate daily costs to manage resources, services and reduce charges. Traditionally, administrators and insurers attempted to decrease costs by reducing the total number of days a person was in a rehabilitation facility. As reductions in length of stay have been made and stabilized, administrators need to look at other cost factors.

This Study

This Study analyzed average daily charges in the inpatient rehabilitation setting for 84 individuals with traumatic brain injury. The total average rehabilitation charges per person were almost $1600 per day and about $46,000 each. Almost 90% of the average daily charges were for room, board, and rehabilitation therapy. Room and board include services that cannot be billed individually and directly to insurance companies, such as nursing care, food services, recreational therapy, administrative costs, hospital maintenance, and utility bills. Room and board services accounted for about 53% of the average daily charges. Rehabilitation therapy was the most expensive fee. The researchers suggest that the costs for rehabilitation staff make up most of the charges. The biggest differences in individual bills occurred during the first week of rehabilitation. During this time, costs for medical and surgical supplies were greatest for persons with severe brain injuries and those who eventually spent longer times in the rehabilitation hospital. The researchers suggest this initial peak in charges may be because individuals had medical problems that were not resolved or identified in the acute-care hospital prior to admission to the rehabilitation setting. Additionally, individuals with more severe injuries received the highest pharmacy bills. Older individuals received less therapy overall and more laboratory test fees.

Who May Be Affected By These Findings

Persons with brain injuries and their families, hospital administrators, health care providers, funding sources, and researchers

Caveats

The researchers suggest those individuals with the greatest medical stability and higher abilities at the time of rehabilitation admission require fewer services and are charged less. The researchers state that administrators may focus cost-reduction strategies on the high cost of rehabilitation personnel instead of the costs associated with managing medical conditions, especially during the first week of rehabilitation admission. Instead, they indicate that administrators may devise ways of using less costly and less qualified personnel, such as “rehabilitation technicians” and more technology to quicken administrative processes.

Bottom Line

The relationship between rehabilitation charges and costs is complex. It appears that charges for room, board, and rehabilitation services make up the largest portion of the bill. The most expensive period appears to occur during the first week of rehabilitation. Bills differed among individuals, and it appeared that those who received the highest charges tended to be older, require more medical services, and spent more days in inpatient rehabilitation.

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Find This Study

Mayer, N. H.; Pelensky, J.; John Whyte, J.; & Fidler-Sheppard, R. (2003). Characterization and correlates of medical and rehabilitation charges for traumatic brain injury during acute rehabilitation hospitalization. Archives of Physical Medicine and Rehabilitation, (84), 242-248.

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