Selecting Patients for Rehabilitation After Acute Stroke: Are There Variations in Practice?
| Autor: | Christine Graven, Sue M. Cotton, Kim Brock, Paul Ilett |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Psychological intervention Physical Therapy Sports Therapy and Rehabilitation Rehabilitation Centers Severity of Illness Index Disability Evaluation Young Adult Social support Case mix index Severity of illness medicine Humans Prospective Studies Prospective cohort study Stroke Diagnosis-Related Groups Aged Multinomial logistic regression Aged 80 and over Rehabilitation business.industry Patient Selection Age Factors Stroke Rehabilitation Social Support Middle Aged medicine.disease Patient Discharge Nursing Homes Acute Disease Physical therapy Female business |
| Zdroj: | Archives of Physical Medicine and Rehabilitation. 91:788-793 |
| ISSN: | 0003-9993 |
| DOI: | 10.1016/j.apmr.2009.11.028 |
| Popis: | Ilett PA, Brock KA, Graven CJ, Cotton SM. Selecting patients for rehabilitation after acute stroke: are there variations in practice? Objective To investigate whether there were variations in practice in selection for rehabilitation after stroke, after adjustment for case mix. Design Prospective multicenter audit. Setting Seven acute stroke units in metropolitan and regional Victoria, Australia. Participants Consecutive acute stroke admissions (N=616). Interventions None. Main Outcome Measures Mobility Scale for Acute Stroke Score and Modified Barthel Index (MBI) scores for continence at day 3 poststroke, discharge destination from the acute hospital. Results Data were analyzed for 616 stroke survivors. Considerable variability in the percentage of cases accessing inpatient rehabilitation was observed in severe stroke (27%–67%) and mild stroke (27%–73%). To assess adjustment for case mix, a multinomial logistic regression was conducted with the outcome variable being discharge destination (home, rehabilitation, or nursing home), and the predictors being Mobility Scale for Acute Stroke Score, MBI continence scores, age, and social situation. The overall amount of variability explained in discharge destination by the predictors was 63% (Nagelkerke pseudo R 2 ). The regression analysis was repeated, adding unit code as a predictor. Unit code was a significant contributor to the model ( P Conclusion The results of the study indicate that, after adjusting for case mix, there may be variations in practice in selection for rehabilitation leading to inequities of access. |
| Databáze: | OpenAIRE |
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