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The Australian National Sub-acute and Non-acute Patient Casemix Classification (AN-SNAP): its application and value in a stroke rehabilitation programme

Peter Disler

Sam Ma

Victorian Rehabilitation Research Institute, Cedar Court Healthsouth Rehabilitation Hospital & University of Melbourne, Australia

Kathy Eagar

Janette Green

Centre for Health Service Development, University of Wollongong, Australia

Stephen de Graaff

Cedar Court Healthsouth Rehabilitation Hospital, Australia

Objective: To investigate whether the Australian National Sub-acute and Non-acute Patient Casemix Classification (SNAP) and Functional Independence Measure and Functional Related Group (Version 2) (FIM-FRG₂) casemix systems can be used to predict functional outcome, and reduce the variance of length of stay (LOS) of patients undergoing rehabilitation after strokes.

Design and setting: The study comprised a retrospective analysis of the records of patients admitted to the Cedar Court Healthsouth Rehabilitation Hospital for rehabilitation after stroke.

Subjects: The sample included 547 patients (83.3% of those admitted with stroke during this period). Patient data were stratified for analysis into the five SNAP or nine FIM-FRG₂ groups, on the basis of the admission FIM scores and age.

Main outcomes: The AN-SNAP classification accounted for a 30.7% reduction of the variance of LOS, and 44.2% of motor FIM, and the FIM-FRG₂ accounts for 33.5% and 56.4% reduction respectively. Comparison of the Cedar Court with the national AN-SNAP data showed differences in the LOS and functional outcomes of older, severely disabled patients. Intensive rehabilitation in selected patients of this type appears to have positive effects, albeit with a slightly longer period of inpatient rehabilitation.

Conclusions: Casemix classifications can be powerful management tools. Although FIM-FRG₂ accounts for more reduction in variance than SNAP, division into nine groups meant that some contained few subjects. This paper supports the introduction of AN-SNAP as the standard casemix tool for rehabilitation in Australia, which will hopefully lead to rational, adequate funding of the rehabilitation phase of care.

Clinical Rehabilitation, Vol. 14, No. 5, 532-537 (2000)
DOI: 10.1191/0269215500cr357oa


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				L. Tooth, K. McKenna, K. Goh, and P. Varghese Length of Stay, Discharge Destination, and Functional Improvement: Utility of the Australian National Subacute and Nonacute Patient Casemix Classification Stroke, July 1, 2005; 36(7): 1519 - 1525. [Abstract] [Full Text] [PDF]