Discharge destination of individuals with severe stroke undergoing rehabilitation: a predictive model

Abstract

Purpose: To determine the predictive value of age, stroke severity and caregiver availability for discharge destination of individuals with severe stroke following inpatient rehabilitation. Methods: Telephone interviews were conducted with individuals recovering from a severe stroke (Rehabilitation Patient Groups 1100 and 1110), who were discharged from a specialized inpatient stroke rehabilitation unit between April 2005 and December 2009, to determine caregiver availability at the time of discharge. Age and Functional Independence Measure (FIM®) scores were obtained retrospectively by chart review. These three variables were analyzed using logistic regression as potential predictors of discharge destination (home versus long-term care). Results: Data from 189 individuals were analyzed. Younger age, higher admission FIM® scores and the presence of a willing and able caregiver were significantly associated with discharge home. Only one individual was discharged home in the absence of a caregiver. Conclusion: Age, admission FIM® and caregiver availability were significant predictors of post-rehabilitation discharge destination. Results of this study suggest that for individuals with severe stroke, discharge home is unlikely in the absence of an available caregiver.

Implications for Rehabilitation

• Age, stroke severity at admission and the availability of a caregiver play an important role in determining post rehabilitation discharge destination of individuals with severe stroke. These factors must be considered to assist with appropriate goal setting and discharge planning during inpatient rehabilitation.

• Long term care
• outcome
• patient discharges
• stroke

Acknowledgements

This project was supported by the Canadian Stroke Network and the Stroke Recovery Association of London, Ontario.