BACKGROUND: "Bounce-backs" (movements from a less intensive to a more intensive care setting) soon after hospital discharge are common, but reasons for bouncing-back remain unknown. OBJECTIVE: To examine how the primary diagnosis for first rehospitalization relates to thirty-day bounce-back number and initial discharge destination in acute stroke. POPULATION: Administrative data from 5,250 Medicare beneficiaries > or = 65 years discharged with acute ischemic stroke in 1998-2000 to a rehabilitation center, skilled nursing facility or home with home health care and with at least one thirty day rehospitalization. ANALYSIS: Probability of thirty-day bounce-back was calculated using multivariate models. RESULTS: Infections and aspiration pneumonitis were the most common reasons for rehospitalization, regardless of initial discharge site. CONCLUSIONS: Efforts addressing aspirations and infections, the preventable complications of immobility, will be critical in decreasing acute stroke bounce-backs.
BACKGROUND: "Bounce-backs" (movements from a less intensive to a more intensive care setting) soon after hospital discharge are common, but reasons for bouncing-back remain unknown. OBJECTIVE: To examine how the primary diagnosis for first rehospitalization relates to thirty-day bounce-back number and initial discharge destination in acute stroke. POPULATION: Administrative data from 5,250 Medicare beneficiaries > or = 65 years discharged with acute ischemic stroke in 1998-2000 to a rehabilitation center, skilled nursing facility or home with home health care and with at least one thirty day rehospitalization. ANALYSIS: Probability of thirty-day bounce-back was calculated using multivariate models. RESULTS: Infections and aspiration pneumonitis were the most common reasons for rehospitalization, regardless of initial discharge site. CONCLUSIONS: Efforts addressing aspirations and infections, the preventable complications of immobility, will be critical in decreasing acute stroke bounce-backs.
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