Chris Grant1, Charles H Goldsmith2, Hubert A Anton3. 1. University of British Columbia, Faculty of Medicine, Division of Physical Medicine and Rehabilitation, Vancouver, BC, Canada; GF Strong Rehabilitation Centre, Vancouver, BC, Canada. Electronic address: Chris.Grant@vch.ca. 2. Simon Fraser University, Faculty of Health Sciences, Burnaby, BC, Canada; Arthritis Research Center of Canada, Richmond, BC, Canada. 3. University of British Columbia, Faculty of Medicine, Division of Physical Medicine and Rehabilitation, Vancouver, BC, Canada; GF Strong Rehabilitation Centre, Vancouver, BC, Canada.
Abstract
OBJECTIVE: To determine rehabilitation length of stay (LOS) for patients with stroke in Canada, and to evaluate which factors contribute to variations in LOS. DESIGN: A retrospective cohort study of Canadians rehabilitating from stroke using medical, functional, and sociodemographic variables extracted from the Canadian Institute for Health Information's National Rehabilitation Reporting System. SETTING: Canadian rehabilitation hospitals providing stroke rehabilitation services. PARTICIPANTS: Patients with stroke (N=11,983) admitted to rehabilitation hospitals from January 2008 through December 2009. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Rehabilitation LOSs were calculated nationally and regionally. Regression models incorporating sociodemographic and clinical measures were constructed to test their effect on LOS. RESULTS: The median stroke rehabilitation LOSs was 35 days (quartiles: 20d, 54d). LOSs varied regionally within Canada. A multivariable regression model including age, FIM motor function scores at admission, and geographic region explained 20% of the variation in LOSs. Modeling these data using a Function-Related Groups case-mix model explained 16% of the variation in LOSs. CONCLUSIONS: FIM motor function scores at admission along with age and geographic region best predicted rehabilitation LOS. These variables explained 20% of the variation in LOSs. Despite regional differences in LOSs, patient characteristics were similar between regions. Other nonpatient factors not captured in these data may contribute to a greater extent in determining stroke rehabilitation LOS.
OBJECTIVE: To determine rehabilitation length of stay (LOS) for patients with stroke in Canada, and to evaluate which factors contribute to variations in LOS. DESIGN: A retrospective cohort study of Canadians rehabilitating from stroke using medical, functional, and sociodemographic variables extracted from the Canadian Institute for Health Information's National Rehabilitation Reporting System. SETTING: Canadian rehabilitation hospitals providing stroke rehabilitation services. PARTICIPANTS: Patients with stroke (N=11,983) admitted to rehabilitation hospitals from January 2008 through December 2009. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Rehabilitation LOSs were calculated nationally and regionally. Regression models incorporating sociodemographic and clinical measures were constructed to test their effect on LOS. RESULTS: The median stroke rehabilitation LOSs was 35 days (quartiles: 20d, 54d). LOSs varied regionally within Canada. A multivariable regression model including age, FIM motor function scores at admission, and geographic region explained 20% of the variation in LOSs. Modeling these data using a Function-Related Groups case-mix model explained 16% of the variation in LOSs. CONCLUSIONS:FIM motor function scores at admission along with age and geographic region best predicted rehabilitation LOS. These variables explained 20% of the variation in LOSs. Despite regional differences in LOSs, patient characteristics were similar between regions. Other nonpatient factors not captured in these data may contribute to a greater extent in determining stroke rehabilitation LOS.
Keywords:
FIM-FRG; FIM–Function-Related Groups; ICD-10 CA; International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Canada; LOS; Length of stay; NRS; National Rehabilitation Reporting System; Rehabilitation; Stroke; length of stay
Authors: Shannon Pike; Anne Cusick; Kylie Wales; Lisa Cameron; Lynne Turner-Stokes; Stephen Ashford; Natasha A Lannin Journal: PLoS One Date: 2021-02-11 Impact factor: 3.240
Authors: Marijn Mulder; Rinske H M Nijland; Judith D M Vloothuis; Maayken van den Berg; Maria Crotty; Gert Kwakkel; Erwin E H van Wegen Journal: PLoS One Date: 2022-01-25 Impact factor: 3.240