Exploring the associations between long-term care and mortality rates among stroke patients.
Information on types of long-term care received by stroke patients after hospital discharge is essential for the formulation of long-term care resource development policy. Comparisons of outcomes resulting from different types of long-term care can provide important considerations in the selection of long- term care services. The purpose of this study is to describe the patterns of long-term care received, and to explore if associations exist between long-term care services and mortality status among stroke patients after hospital discharge. Using a longitudinal quasi-experimental study design, this study collected information on the type of long-term care received at 1, 3, and 6 months after discharge for 714 patients. At one month after discharge, 4.5 % had died, and 22.1 % had regained all functions in activities of daily living and instrumental activities of daily living. The percentage of patients receiving institutional care, home or community-based care, and family care only were 10.4 % , 22.4 % , and 40.7 % respectively. The respective percentages at 3 months after discharge were 11.2 % , 18.7 % , and 38.0 % , and, at 6 months after discharge, 10.3 % , 19.4 % , and 30.9 % . After adjusting for age, sex, previous incidence of stroke, and physical functions, the odds of dying within 6 months after discharge for stroke patients receiving home or community-based care was significantly lower than those in institutions ( OR = 0.39; 95 % CI = 0.15 to 0.97 ). It is not clear why a lower mortality rate was observed among patients receiving home or community-based services. Differences in quality of care and quality of life among users of different types of long-term care services should be investigated. More research is needed to assess the causes of the disparity in mortality rates among users of different types of long-term care services.
School of Public Health, College of Public Health and Nutrition, Taipei Medical University.
Kun-Yang
KY
Chuang
Shwu-Chong
SC
Wu
Mei Chang
MC
Yeh
Yu-Hui
YH
Chen
Chen-Long
CL
Wu
D000203:Activities of Daily Living; D000368:Aged; D003153:Community Health Services / Q000458:organization & administration*; D005260:Female; D015577:Geriatric Assessment; D006302:Health Services Research; D006699:Home Care Services / Q000458:organization & administration*; D006701:Home Nursing / Q000458:organization & administration*; D006801:Humans; D016015:Logistic Models; D008134:Long-Term Care / Q000458:organization & administration*; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D015397:Program Evaluation; D011787:Quality of Health Care / Q000592:standards; D011788:Quality of Life; D012866:Skilled Nursing Facilities / Q000458:organization & administration*; D020521:Stroke / Q000401:mortality* / Q000523:psychology; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors