Predictors of resource use after acute hospitalization

Rundek, Tatjana; Mast, H.; Hartmann, Andreas; Boden‐Albala, Bernadette; Lennihan, Laura; Lin, I.-Ching; Paik, M. C.; Sacco, Ralph L.

doi:10.1212/wnl.55.8.1180

Cited by 94 publications

(104 citation statements)

References 26 publications

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“…There are many reports that patients with severe neurological deficits have increased risk of being sent to a care facility or other hospital (Silliman et al 1987;Lai et al 1998;Rundek et al 2000;Bohannon et al 2002;Chang et al 2002;Glader et al 2003;Jimenez Muro et al 2003;Schlegel et al 2003). Neurological deficit appears to be a very strong predictor for not being discharged to home.…”

Section: Discussionmentioning

confidence: 99%

“…For stroke patients, the effect of family structure on resource use is poorly documented (Lai et al 1998;Rundek et al 2000;Chang et al 2002;Glader et al 2003;Jimenez Muro et al 2003;Schlegel et al 2003). Living alone before the stroke was reported to be a risk factor for institutionalization after hospitalization for acute stroke (Rundek et al 2000;Glader et al 2003).…”

Section: Discussionmentioning

confidence: 99%

“…Of these, stroke severity (Silliman et al 1987;Lai et al 1998;Rundek et al 2000;Bohannon et al 2002;Chang et al 2002;Glader et al 2003;Jimenez Muro et al 2003;Schlegel et al 2003), such as neurological deficit and functional dependency, and older age (Lai et al 1998;Rundek et al 2000;Glader et al 2003), were related to a lower likelihood of discharge to home.…”

confidence: 99%

“…Previous studies have identified clinical (Silliman et al 1987;Lai et al 1998;Rundek et al 2000;Bohannon et al 2002;Chang et al 2002;Glader et al 2003;Jimenez Muro et al 2003;Schlegel et al 2003) and demographic (Lai et al 1998;Rundek et al 2000;Chang et al 2002;Glader et al 2003;Jimenez Muro et al 2003) factors related to discharge to home after hospitalization for acute stroke. Of these, stroke severity (Silliman et al 1987;Lai et al 1998;Rundek et al 2000;Bohannon et al 2002;Chang et al 2002;Glader et al 2003;Jimenez Muro et al 2003;Schlegel et al 2003), such as neurological deficit and functional dependency, and older age (Lai et al 1998;Rundek et al 2000;Glader et al 2003), were related to a lower likelihood of discharge to home.…”

confidence: 99%

“…Living alone before stroke was reported to be a risk factor for institutionalization after acute stroke hospitalization (Rundek et al 2000;Glader et al 2003). It is estimated that approximately 80% of stroke survivors require help from informal caregivers for daily living; these caregivers are often family members (Anderson et al 1995;Dewey et al 2002).…”

confidence: 99%

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Gender and Family Composition Related to Discharge Destination and Length of Hospital Stay after Acute Stroke

Ohwaki

Hashimoto

Tokuda

et al. 2005

Tohoku J. Exp. Med.

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Informal care by family members still plays an important role in home care after acute stroke. This study determined the clinical and demographic factors, such as family structure, that predict discharge to home and length of hospital stay (LOS) after acute stroke hospitalization. We reviewed the sex, age, family structure before stroke, type of stroke, size of the lesion, activities of daily living (ADL) function at discharge, discharge destination, and LOS of stroke patients (114 cerebral infarctions and 44 intracerebral hemorrhages) admitted to a neurosurgical hospital. Patients with cerebral infarction were older than those with intracerebral hemorrhage (median 75 vs 66 years). Ninety-eight were discharged to home (62%). In the logistic regression analysis, low ADL function, medium or large infarction, and intracerebral hemorrhage (vs lacunar infarction) were significantly associated with discharge to a destination other than home. Of the patients discharged home, low ADL function was strongly associated with LOS in the multiple regression analysis. In addition, living with a spouse only had the opposite effect on LOS in men and women ( p = 0.050 and 0.071, respectively). LOS tended to be shorter for men with a wife, but longer for women with a husband. The structure and gender roles in a stroke patient's household may need further attention for the efficient use of hospital resources.gender; family; stroke outcome; hospitalization © 2005 Tohoku University Medical PressStroke remains the third highest cause of mortality in Japan, resulting in 130,000 deaths per year (Ministry of Health, Labour and Welfare 2004). Although the fatality rate has decreased in the last few decades, a large number of acute survivors still suffer functional disabilities that lead to institutionalization and a consequent economic burden on the patient's household and society as a whole. With the rapid increase in the population of elderly, it is even more important to identify stroke patients who are at risk of a prolonged hospital stay in order to enhance their return home.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Gender and Family Composition Related to Discharge Destination and Length of Hospital Stay after Acute Stroke

Ohwaki

Hashimoto

Tokuda

et al. 2005

Tohoku J. Exp. Med.

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Prediction of Hospital Disposition After Thrombolysis for Acute Ischemic Stroke Using the National Institutes of Health Stroke Scale

Schlegel¹,

Tanné

Demchuk

et al. 2004

Arch Neurol

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Transitions of care for stroke and TIA

Haynes

Gallek

Sheppard

et al. 2015

Journal of the American Association of Nurse Practitioners

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Purpose The purpose of this study was to identify elements of a stroke population that may affect transitions of care (TOC). Data sources A retrospective analysis of the demographic characteristics of patients from an urban primary stroke center with an admitting diagnosis of transient ischemic attack, acute ischemic stroke, subarachnoid hemorrhage, or intracerebral hemorrhage was performed over an 8‐month period (N = 276). A subset of this patient sample participated in a telephone survey 1 month after discharge. Conclusion Hospital length of stay, age, insurance status, discharge disposition, comorbidities, and readmission rates were identified as important elements affecting TOC for stroke and TIA. Information from patient surveys indicated that emotional health, follow‐up with care providers, stroke education, and point of contact are important elements during the transition periods after stroke and TIA. Implications for practice Both providers and patients should inform the development of a comprehensive TOC program that spans in‐hospital to multiple care settings, including the home, which is essential. The advanced practice nurse is ideally suited to successfully lead these programs.

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Predictors of resource use after acute hospitalization

Cited by 94 publications

References 26 publications

Gender and Family Composition Related to Discharge Destination and Length of Hospital Stay after Acute Stroke

Gender and Family Composition Related to Discharge Destination and Length of Hospital Stay after Acute Stroke

Prediction of Hospital Disposition After Thrombolysis for Acute Ischemic Stroke Using the National Institutes of Health Stroke Scale

Transitions of care for stroke and TIA

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