title: Rehabilitation social workers: measuring their ability to predict discharge destination of rehabilitation patients.
abstract: Most rehabilitation centers only admit patients for rehabilitation who have a reasonable chance of being discharged to a noninstitutional setting. With certain classifications, such as stroke, 20 to 30% of patients are often discharged to a skilled nursing facility (SNF). Problems associated with rehabilitation admission procedures make careful psychosocial determinations difficult. We attempted to have experienced rehabilitation social workers predict discharge placement following a formal evaluation. Three experienced rehabilitation social workers met formally with patients and/or families for an initial interview following admission to the rehabilitation unit. They assessed the functional goals developed by the rehabilitation team and predicted which patients would go home and which would go to a SNF. Their predictions were compared to the actual discharge placement. A chi square test revealed that the social workers accurately predicted discharge home but were unable to accurately predict which patients would go to an SNF. Of those predicted to return home, 95% did so. Of those predicted to go to an SNF, only 57% did so. Of the total sample of 126 patients, 86% were discharged home and 14% were discharged to an SNF. This finding suggests that patients should not be denied a trial of rehabilitation solely on the basis of projected discharge placement.
mesh_terms: D000359:Aftercare; D002140:California; D005260:Female; D006801:Humans; D007326:Institutionalization; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011379:Prognosis; D012046:Rehabilitation; D012047:Rehabilitation Centers; D012947:Social Work; D012948:Social Work Department, Hospital