Accessing Inpatient Rehabilitation after Acute Severe Stroke: Age, Mobility, Prestroke Function and Hospital Unit Are Associated with Discharge to Inpatient Rehabilitation

Autor/inn/en	Hakkennes, Sharon; Hill, Keith D.; Brock, Kim; Bernhardt, Julie; Churilov, Leonid
Titel	Accessing Inpatient Rehabilitation after Acute Severe Stroke: Age, Mobility, Prestroke Function and Hospital Unit Are Associated with Discharge to Inpatient Rehabilitation
Quelle	In: International Journal of Rehabilitation Research, 35 (2012) 4, S.323-329 (7 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0342-5282
DOI	10.1097/MRR.0b013e328355dd00
Schlagwörter	Foreign Countries; Patients; Hospitals; Rehabilitation; Neurological Impairments; Brain; Age Differences; Physical Disabilities; Daily Living Skills; Caregivers; Psychomotor Skills; Human Body; Communication Skills; Australia + Suchen Sie Ihr Suchwort? Ausland; Patient; Krankengymnast; Krankenhaus; Neurodegenerative Erkrankung; Gehirn; Age; Difference; Age difference; Altersunterschied; Physical handicap; Körperbehinderung; Alltagsfertigkeit; Caregiver; Carer; Betreuungsperson; Pfleger; Psychomotorische Aktivität; Menschlicher Körper; Kommunikationsstil; Australien
Abstract	The objective of this study was to identify the variables associated with discharge to inpatient rehabilitation following acute severe stroke and to determine whether hospital unit contributed to access. Five acute hospitals in Victoria, Australia participated in this study. Patients were eligible for inclusion if they had suffered an acute severe stroke (Mobility Scale for Acute Stroke [less than or equal to] 15). Physiotherapists assessed patients on day 3 poststroke, collecting demographic information and information relating to their prestroke status, social status and current status. Stepwise logistic-regression modelling was used to examine the association between age, type of stroke, prestroke living situation, comorbidities, availability of carer on discharge, current mobility, bladder continence, bowel continence, cognition and communication and the dependent variable, discharge destination (rehabilitation/other). The resulting model was analysed using hierarchical logistic regression with hospital unit as the clustering variable. Of the 108 patients fulfilling the inclusion criteria, 70 (64.8%) were discharged to rehabilitation. The variables independently associated with discharge to rehabilitation were younger age [odds ratio (OR)=0.89, 95% confidence interval (CI)=0.83-0.95, P=0.001], independent premorbid functional status (OR=14.92, 95% CI=2.43-91.60, P=0.004) and higher level of current mobility (OR=1.31, 95% CI=1.02-1.66, P less than 0.03). The multilevel model estimated that 12% of the total variability in discharge destination was explained by differences between the hospital units (p=0.12, 95% CI=0.02-0.55, P=0.048). The results indicate that the variables associated with discharge to rehabilitation following severe stroke are younger age, independent prestroke functional status and higher level of current mobility. In addition, organizational factors play a role in selection for rehabilitation, suggesting inequity in access for this patient group. (Contains 3 tables and 1 figure.) (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10