Vu Q C Nguyen1, Janet PrvuBettger2, Tami Guerrier3, Mark A Hirsch3, J George Thomas3, Terrence M Pugh3, Charles F Rhoads3. 1. Department of Physical Medicine and Rehabilitation, Carolinas Medical Center, Charlotte, NC. Electronic address: vu.nguyen@carolinashealthcare.org. 2. School of Nursing, Duke University, Durham, NC. 3. Department of Physical Medicine and Rehabilitation, Carolinas Medical Center, Charlotte, NC.
Abstract
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.
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.
Authors: Terrence Pugh; Mark A Hirsch; Vu Q C Nguyen; Charles F Rhoads; Gabrielle M Harris; Qing Yang; J George Thomas; Tami Guerrier; Deanna Hamm; Carol Pereira; Jia Yao; Janet A Prvu Bettger Journal: Am J Phys Med Rehabil Date: 2019-04 Impact factor: 2.159
Authors: Gabrielle M Harris; Janice Collins-McNeil; Qing Yang; Vu Q C Nguyen; Mark A Hirsch; Charles F Rhoads; Tami Guerrier; J George Thomas; Terrence M Pugh; Deanna Hamm; Carol Pereira; Janet Prvu Bettger Journal: J Stroke Cerebrovasc Dis Date: 2016-10-06 Impact factor: 2.136
Authors: Robert Cavanaugh; Christina Kravetz; Lillian Jarold; Yina Quique; Rose Turner; William S Evans Journal: Am J Speech Lang Pathol Date: 2021-08-19 Impact factor: 2.408
Authors: Jennifer K Burton; Eilidh E C Ferguson; Amanda J Barugh; Katherine E Walesby; Alasdair M J MacLullich; Susan D Shenkin; Terry J Quinn Journal: J Am Geriatr Soc Date: 2017-10-09 Impact factor: 5.562