Bouncing-back: rehospitalization in patients with complicated transitions in the first thirty days after hospital discharge for acute stroke.
BACKGROUND
"Bounce-backs" (movements from a less intensive to a more intensive care setting) soon after hospital discharge are common, but reasons for bouncing-back remain unknown.


OBJECTIVE
To examine how the primary diagnosis for first rehospitalization relates to thirty-day bounce-back number and initial discharge destination in acute stroke.


METHODS
Administrative data from 5,250 Medicare beneficiaries > or = 65 years discharged with acute ischemic stroke in 1998-2000 to a rehabilitation center, skilled nursing facility or home with home health care and with at least one thirty day rehospitalization.


METHODS
Probability of thirty-day bounce-back was calculated using multivariate models.


RESULTS
Infections and aspiration pneumonitis were the most common reasons for rehospitalization, regardless of initial discharge site.


CONCLUSIONS
Efforts addressing aspirations and infections, the preventable complications of immobility, will be critical in decreasing acute stroke bounce-backs.
Kind
Amy J H
AJ
Department of Population Health Sciences, Geriatrics Division, University of Wisconsin School of Medicine and Public Health, Wadison, WI, USA. ajk@medicine.wisc.edu
Smith
Maureen A
MA
Pandhi
Nancy
N
Frytak
Jennifer R
JR
Finch
Michael D
MD
D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008329:Managed Care Programs; D010351:Patient Discharge; D010359:Patient Readmission / Q000639:trends*; D020521:Stroke / Q000150:complications* / Q000401:mortality; D014481:United States / Q000453:epidemiology