FIM SCORES AS AN INDICATOR OF LENGTH OF STAY FIM Scores as an Indicator of Length of Stay and Discharge Destination in CVA Patients: A Retroactive Outcomes Study

The Functional Independence Measure (FIM) scale is used in in-patient occupational therapy to measure progress of functional skills such as dressing, bathing, and eating. The recent changes in healthcare, transitioning from fee-for-service to capitative service delivery model, are requiring therapists to advance their skills in the area of prognostics. If the FIM can be used as an outcomes predictor, therapists may more accurately determine patient outcomes, and upon admission, address the psychosocial effects of transition from hospital to discharge placement early in treatment. Eighty-two charts were reviewed at a large medical facility in western Wisconsin from the years 1994 and 1998. This retroactive outcomes study explores the ability of the FIM to predict length of stay (LOS) and discharge destination of stroke survivors over the age of 65. Both logistical and multinomial regressions were used to analyze data. Statistical models were constructed to determine if the initial total FIM score and the initial self-care total FIM score predict discharge destination. These models showed significance, with p<.001 and p<.004, respectively. Initial total FIM and initial self-care total FIM scores also predict LOS in CVA patients, with initial selfcare FIMs being a more significant predictor. In conclusion, the FIM score may be used as an outcomes predictor in CVA patients.