Hospital disposition after stroke in a national survey of acute cerebrovascular diseases in Israel.
OBJECTIVE
To investigate predictive factors for disposition after acute stroke.


METHODS
A nationwide survey (2004 National Acute Stroke Israeli Survey).


METHODS
All 28 primary general medical centers operating in Israel.


METHODS
Acute stroke patients (n=1583) admitted during February and March 2004 and discharged from the primary hospital.


METHODS
Data collected on baseline characteristics, stroke presentation, type and severity, in-hospital investigation and complications, discharge disability, acute hospital disposition, and mortality follow-up.


METHODS
Hospital disposition to home, acute rehabilitation, or nursing facility.


RESULTS
Among patients, 58.9% (n=932) were discharged home, 33.7% (n=534) to rehabilitation departments, and only 7.4% (n=117) to nursing facilities. Admission neurologic status was a good predictor of hospital disposition. Patients with severe strokes were mostly discharged to rehabilitation facilities. Patients with significant functional decline before the index stroke, resulting from a previous stroke or another cause, were sent to inpatient rehabilitation less frequently. Disability level at discharge from acute hospitalization had high predictive value in hospital disposition after stroke. In the northern region of Israel, a higher proportion of patients were sent home and a lower proportion to rehabilitation and nursing facilities, probably because of lower availability of rehabilitation care in this region of Israel.


CONCLUSIONS
This nationwide survey shows that most stroke survivors in Israel are discharged home from the acute primary hospital. Good functional status before the index stroke is an important predictor for being sent to acute inpatient rehabilitation. Severity of neurologic impairment and level of disability after the stroke at discharge from the primary hospital are strong predictors for disposition after stroke in Israel. Our data may be useful in discharge planning for stroke patients by policy-makers and health care providers in Israel.
Treger
Iuly
I
Loewenstein Rehabilitation Center, Ra'anana, Israel.
Ring
Haim
H
Schwartz
Roseline
R
Tsabari
Rakefet
R
Bornstein
Nathan M
NM
Tanne
David
D
D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000401:mortality / Q000534:rehabilitation*; D015331:Cohort Studies; D005260:Female; D019538:Health Care Surveys; D006701:Home Nursing / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007557:Israel; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000592:standards* / Q000639:trends; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D020127:Recovery of Function; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D016019:Survival Analysis; D016896:Treatment Outcome