Using rehabilitation treatment data to examine associations between input (treatment) and output (treatment effectiveness) in medical rehabilitation

Scientific Research Project Number: MA 2019 17
Place: De Hoogstraat Revalidatie, Utrecht

Introduction

De Hoogstraat Revalidatie is one of the largest rehabilitation hospitals in the Netherlands. De Hoogstraat offers inpatient and outpatient rehabilitation programs for people with physical disabilities, such as spinal cord injury, stroke, traumatic brain injury and amputation. Within De Hoogstraat, a small Business Intelligence (BI) team is responsible for data governance and information management. The team is part of the Department of Business Control.

De Hoogstraat was one of the first rehabilitation centers in the Netherlands to adopt routine measurement of treatment outcomes (increase in functional status between admission and discharge). An instrument, the Utrecht Scale for Evaluation of Rehabilitation was developed for this goal and is in use since 2005. Further, from its start in 2015, De Hoogstraat participated in a national project to develop a new payment system for medical rehabilitation. During this time, all team members (e.g., physical therapist, speech-language therapist, etc.) registered all their treatments using a comprehensive and detailed classification system. Information on 100000+ treatments for about 1000 patients and their functional status at admission and discharge from inpatient rehabilitation is stored in the respective databases.


Description of the SRP Project/Problem

In medical rehabilitation it is difficult to establish a clear association between the input (amount and type of treatment) and output (client’s gain in functional status) of treatment. One reason is the complexity of rehabilitation treatment. Patients usually have unique and multiple pathologies and treatment goals, treatment is therefore tailored to individual needs, and provided by large multidisciplinary teams consisting of many disciplines. However, the current lack of knowledge on the association between input and output hampers assessment of the effectiveness and efficiency of rehabilitation and thereby quality improvement.

Two previous students in medical informatics investigated respectively the possibilities to utilize the databases of De Hoogstraat for this goal and possibilities to cluster treatments into meaningful and analysable categories. We are now looking for a master student to build on this work and analyse associations between input and output.


Research questions

1. What are the associations between functional limitations at admission of rehabilitation and treatment (amount, duration, type) provided?

2. What are the associations between treatment provided and client’s gain in functional status during rehabilitation?

3. Are these associations similar across diagnostic groups?

4. What recommendations can be made for improvement of treatment registration and outcome measurement and what recommendations can be made to improve the effectiveness of rehabilitation?


Expected results

The student will read and summarize relevant literature, generate an analysable dataset from multiple database using SQL queries, perform statistical analyses and write a report.

Based on this work the student will write a Master Thesis with documentation of search strategies and scripts. The Thesis will be written in the format of a scientific publication and we hope it will be close-to-ready for submission to an international peer-reviewed journal.


Time period

Seven months


References

Information on De Hoogstraat Revalidatie is available at www.dehoogstraat.nl

The Theses of the previous Bachelor and Master students are available on request.


Contact

Ronald Beuker MSc, Business Intelligence Manager, De Hoogstraat Revalidatie - www.dehoogstraat.nl, r.beuker@dehoogstraat.nl 030-2561389
Prof.dr. Marcel Post, Senior Researcher and professor of rehabilitation medicine, , m.post@dehoogstraat.nl