Skilled nursing facility rehabilitation and discharge to home after stroke.
OBJECTIVE
To determine the relation between rehabilitation therapy (RT) intensity and time to discharge home for stroke patients in skilled nursing facilities (SNFs).


METHODS
Retrospective cohort study. We used regression analyses, stratified by expected outcome, and propensity score adjustment. Setting All SNFs in Ohio, Michigan, and Ontario, Canada.


METHODS
A cohort of residents, aged 65 and over, admitted from hospitals to SNFs with a diagnosis of stroke (N=23,824).


METHODS
Not applicable.


METHODS
Time to discharge home from an SNF.


RESULTS
RT was given to more than 95% of residents for whom discharge was expected within 90 days and to more than 60% of residents for whom discharge was uncertain or not expected. RT increased the likelihood of discharge to the community for all groups except those expected to be discharged within 30 days. The dose-response relation was strongest for residents with either an uncertain discharge prognosis or no discharge expected.


CONCLUSIONS
Postacute residents with an uncertain prognosis are an important target population for intensive RT.
Wodchis
Walter P
WP
Toronto Rehabilitation Institute Toronto, ON Canada.
Teare
Gary F
GF
Naglie
Gary
G
Bronskill
Susan E
SE
Gill
Sudeep S
SS
Hillmer
Michael P
MP
Anderson
Geoff M
GM
Rochon
Paula A
PA
Fries
Brant E
BE
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data*; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome