photo of Anne Deutsch, a middle-aged white woman with short blonde hair

New research tracks trends and outcomes of older patients with non-traumatic spinal cord injury treated in inpatient rehabilitation facilities


Between 2013 and 2018, the number of Medicare patients with non-traumatic spinal cord injury (SCI) increased by more than 22%, according to a new study published in The Journal of Spinal Cord Medicine

Researchers led by Anne Deutsch, PhD, RN, a research scientist in the Center for Rehabilitation Outcomes Research at Shirley Ryan AbilityLab, looked at data from the Inpatient Rehabilitation Facility – Patient Assessment Instrument (IRF-PAI) for Medicare patients with non-traumatic spinal cord injury treated at inpatient rehabilitation facilities between 2013 and 2018. The data included information on demographics, inpatient rehabilitation stay, functional status and other clinical data. 

The researchers analyzed information from 125,281 inpatient rehabilitation stays for Medicare (Medicare fee-for-service and Medicare Advantage) beneficiaries (65 years old and older) with NTSCI who were discharged from 1,263 inpatient rehabilitation facilities.

They found that the number of patients increased 22% from 14,149 in 2013 to 17,275 in 2018. The researchers note that the increase is higher than the growth in the number of older Medicare beneficiaries overall, which increased by 16.9% during this same time period. 

“We also saw a higher percentage of more medically complex patients over the years, even though the length of the rehabilitation stay was generally the same,” says Deutsch. “These patients need specialized care so with more patients and more patients with complex needs, there is a need for more clinicians who have specialized training and experience.”

The researchers also found:

  • Age distribution of patients shifted, with a higher percentage of patients in the 65- to 74-year-old range, and a lower percentage in the 85 years old and older range by 2018
  • The sex ratio also shifted to a higher percentage of males, from 49.9% in 2013 to 54.2% in 2018 
  • Just over 40% of patients had a history of falls prior to their non-traumatic SCI
  • More than three-quarters of patients were independent with self-care, indoor mobility and functional cognition activities prior to admission to an inpatient rehabilitation facility
  • Almost half (47%) of patients previously used a walker
  • Median length of stay remained the same, at 12 days
  • Discharge self-care and mobility function increased slightly
  • The percent of patients discharged to home was similar across the years

Allison Kessler, MD and Jenny Burns of Shirley Ryan AbilityLab and John Potelle of RTI International, are co-authors on the paper.

This research was funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (grant 90SIMS0015), the Centers for Medicare & Medicaid Services (contract HHSM-500-2013-13015I), and RTI International.