Effect of functional gain on satisfaction with medical rehabilitation after stroke.
OBJECTIVE
To examine the association between gain in motor and cognitive functional status with patient satisfaction 3-6 mo after rehabilitation discharge.


METHODS
Patient satisfaction and changes in functional status were examined in 18,375 patients with stroke who received inpatient medical rehabilitation. Information was obtained from 144 hospitals and rehabilitation facilities contributing records to the Uniform Data System for Medical Rehabilitation and the National Follow-up Services.


RESULTS
Data analysis revealed significant (P < 0.05) differences in satisfaction responses based on whether information was collected from patient self-report or from a family member proxy, and the two subsets were analyzed separately. Logistic regression revealed the following significant predictors of satisfaction for data collected from stroke patients: cognitive and motor gain, rehospitalization, who the patient was living with at follow-up, age, and follow-up therapy. In the patient-reported data subset, compared with patients who showed improved cognitive or motor functional status, those with no change, respectively, had a 31% and 33% reduced risk of dissatisfaction. In addition, rehospitalized patients had a higher risk of dissatisfaction. For the proxy reported data subset, significant influences on satisfaction were health maintenance, rehospitalization, stroke type, ethnicity, cognitive FIM gain, length of stay, and follow-up therapy.


CONCLUSIONS
Ratings of satisfaction with rehabilitation services were affected by change in functional status and whether the information was collected from patient rating or proxy response.
Tooth
Leigh R
LR
School of Population Health, University of Queensland, Brisbane, Australia.
Ottenbacher
Kenneth J
KJ
Smith
Pamela M
PM
Illig
Sandra B
SB
Linn
Richard T
RT
Gonzales
Vera A
VA
Granger
Carl V
CV
D000367:Age Factors; D000368:Aged; D003071:Cognition; D003625:Data Collection / Q000379:methods; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D010359:Patient Readmission; D017060:Patient Satisfaction; D011597:Psychomotor Performance; D012111:Residence Characteristics; D000071939:Stroke Rehabilitation; D014481:United States