Factors related to home discharge of cerebrovascular disease patients: 1-year follow-up interview survey of caregivers of hospitalized patients in 53 acute care hospitals in Japan.

In Japan, many disabled elderly people remain hospitalized for long periods. Cerebrovascular diseases (CVD) are the most causes responsible for such disability. To examine the predictors of home discharge in CVD patients, we performed a 1-year follow-up interview of the main caregivers of patients hospitalized with a CVD event. The initial cohort consisted of CVD patients hospitalized in all the second level emergency and general hospitals in Ibaraki Prefecture in February 1992 (N=888 patients in 53 hospitals). In the following year, we performed an interview survey of the main caregivers of these CVD patients. The survey items included the characteristics of the patients (including medical and socioeconomic conditions), caregivers, and family members. The final study population included the main caregivers of 187 home patients and 90 institutionalized patients. We compared these two groups in terms of predictors of discharge to home. The results of multiple logistic regression analysis showed that the following seven factors were related to home discharge; better baseline activities of daily living (ADL), larger improvement in ADL, larger family size, spouse as the caregiver, caregiver without a full-time job, better economic status of the caregiver, and sources of the patient's income. Our study indicated that the caregiver's conditions were closely related to home discharge of the CVD patients. More attention should, therefore, be centered on the caregiver's well-being and economic aspects as well as the patient's conditions in order to encourage home discharge of stroke patients.