Article

OBJECTIVE: To examine sociodemographic and clinical characteristics independently
associated with discharge home compared with discharge to a skilled nursing
facility (SNF) after acute inpatient rehabilitation.
DESIGN: Retrospective cohort
study. SETTING: Three tertiary accredited acute care rehabilitation facilities.
PARTICIPANTS: Adult patients with stroke (N=2085). INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Not applicable. RESULTS: Of 2085 patients with stroke
treated at 3 centers over a 4-year period, 78.2% (n=1631) were discharged home
and 21.8% (n=454) discharged to an SNF. Findings from a multivariable logistic
regression analysis indicated that patients were less likely to be discharged
home if they were older (odds ratio [OR], .98; 95% confidence interval [CI],
.96-.99), separated or divorced (compared with married; OR, .61; 95% CI,
.48-.79), or with Medicare health insurance (compared with private insurance; OR,
.69; 95% CI, .55-.88), or had dysphagia (OR, .83; 95% CI, .71-.98) or cognitive
deficits (OR, .79; 95% CI, .77-.81). The odds of being discharged home were
higher for those admitted with a higher motor FIM score (OR, 1.10; 95% CI,
1.09-1.11). The following were not associated with discharge disposition: sex,
race, prestroke vocational status, availability of secondary health insurance,
number of days from stroke onset to rehabilitation facility admission, stroke
type, impairment group, cognitive FIM on admission, other stroke deficits
(aphasia, ataxia, neglect, or speech disturbance), stroke complications of
hyponatremia or urinary tract infection, or comorbid conditions. CONCLUSIONS: One
in 5 patients with stroke were discharged to an SNF after inpatient
rehabilitation. On admission, several sociodemographic and clinical
characteristics were identified that could be considered as important factors in
early discussions for discharge planning.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS