[A study of factors influencing determination of discharge disposition of stroke rehabilitation patients].
OBJECTIVE
The purpose of this study is to statistically analyze medical and socioeconomic factors which influence discharge disposition from a stroke unit.


METHODS
We investigated 126 stroke patients admitted to a community hospital within 30 days from the onset of the stroke. Mean age was 65.9 +/- 13.9 (SD) years old, profile of diagnosis was 89 infarctions was 37 hemorrhages, and mean length of stay was 79.7 +/- 45.1 days. Our rehabilitation team consists of doctors, nurses, physical therapists, occupational therapists and a medical social worker. Our stroke unit accepted the stroke patients from the time of admission and attempted to begin rehabilitation as soon as possible. The patients and their families were informed about their options after discharge from the hospital. Eight factors were analyzed using a multiple logistic regression model.


RESULTS
1) Ninety-eight patients (77.8%) could return home (home group) and 28 patients (22.2%) were discharged to another hospital or a long-term care facility (LTCF group). 2) Mean age of LTCF group (70.3 +/- 12.0) was significantly higher than the home group (64.8 +/- 14.2, p < 0.05). The home group showed milder leg paresis (p < 0.01), better Barthel index (p < 0.01), a higher number of family members (p < 0.05), and a better substantial care ability (p < 0.01) than LTCF group. 3) Three factors, higher Barthel index (odds ratio: 1.36), higher number of family members (1.84), and better substantial care ability (1.94), were found to facilitate discharge to home. Two other factors, hemorrhage (0.39) and public assistance (0.04), adversely affected the likelihood of discharge to home.


CONCLUSIONS
This study suggests that a stroke unit could accelerate discharge home by improving the Barthel index. In addition, socioeconomic factors should be taken into consideration.
Kondo
K
K
Faculty of Social Welfare, Nihon Fukushi University, Aichi.
Adachi
M
M
D000368:Aged; D005190:Family; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D020521:Stroke / Q000175:diagnosis; D000071939:Stroke Rehabilitation