Characterising Baseline Complexity in Rehabilitation Patients Using the Rehabilitation Complexity Scale (RCS-E)

Abstract Background Accurately characterizing patient complexity on admission to rehabilitation is essential for care planning, resource allocation, and outcome prediction. The Rehabilitation Complexity Scale – Extended (RCS-E) (1) offers a framework to quantify clinical, nursing, and therapy needs in this context. This study aims to describe the baseline complexity of patients admitted to inpatient rehabilitation settings using the RCS-E and explore the distribution of complexity domains across the cohort. Methods A prospective cohort study was conducted involving 22 patients admitted to a post-acute care rehabilitation Hospital over a 6 week period. RCS -E scores were collected at admission and analysed across its five domains: “Medical, Nursing, Therapy Disciplines, Therapy Intensity, and Equipment needs.” Data were collected on demographics, clinical characteristics, frailty scores and polypharmacy. Results The mean age of patients included in this study was 79, 11(50%) patients were male and 11(50%) were female. The median total RCS-E score at admission was 11(range: 7-16) indicating moderate rehabilitation complexity. 4.5% were high complexity, 91% moderate and 4.5% low. The therapy disciplines domain was the greatest contributor to higher complexity scoring. Patients with a CFS score(36%) indicating higher levels of frailty, were associated with higher nursing, therapy and medical needs compared to those with lower frailty scores. Polypharmacy, the use of five or more medications, was present in 86% of the study population. Conclusion Understanding complexity patterns amongst patients admitted to rehabilitation can inform care planning and support resource allocation. At present there is an absence of published Irish research using the RCS-E as a tool for evaluating rehabilitation complexity. Implementing a standardised screening tool to assess rehabilitation complexity is critical to ensuring that services are matched to patient needs, facilitating more efficient resource allocation and improving overall care outcomes. Reference 1. The Rehabilitation Complexity Scale: extended (version 13). Available at: https://www.kcl.ac.uk/nmpc/assets/rehab/rcs-e-v13-with-guidelines-score-sheet.pdf.