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Predictors of inpatient rehabilitation after total knee replacement: an analysis of private hospital claims data

Chris Schilling, Anna Barker and Stephen F Wilson
Med J Aust 2019; 210 (2): 101. || doi: 10.5694/mja2.12065
Published online: 4 February 2019

In reply: We welcome the debate about the choice of rehabilitation at home as an effective treatment option. Our study1 supports the position statement of the Rehabilitation Medicine Society of Australia and New Zealand (RMSANZ)2 and the comments of the Australasian Faculty of Rehabilitation Medicine of the Royal Australasian College of Physicians which recommend inpatient rehabilitation be based on patient need. We considered many clinically relevant patient factors identified in the position statement, including age, socio‐economic status, comorbidities, living alone and surgical complications.1,2 Large interhospital variation in inpatient rehabilitation persisted after adjustment for these factors. It seems implausible, given the large sample, that unobserved patient factors could explain the wide variation (76% in one large volume private hospital, 10% in another1), but we acknowledge our study could be improved with function and obesity measures in particular.

  • Chris Schilling1
  • Anna Barker2
  • Stephen F Wilson3

  • 1 KPMG Australia, Melbourne, VIC.
  • 2 Medibank Private, Melbourne, VIC.
  • 3 University of Sydney, Sydney, NSW.

Correspondence: cschilla@gmail.com

Acknowledgements: 

Catherine Keating and Dennis Petrie contributed to the research that is discussed in this letter. Catherine Keating is employed by Medibank Private. Dennis Petrie is supported by Monash University and an Australian Research Council Discovery Early Career Researcher Award.

Competing interests:

Anna Barker is employed by Medibank Private and receives salary support from Monash University. Chris Schilling is employed by KPMG and received consultancy fees from Medibank Private to undertake the analysis discussed in this article. Stephen Wilson has previously received consultancy fees from Medibank Private in relation to development of rehabilitation in the home.

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