Article

OBJECTIVES: To explore the key factors involved in decision making when selecting
patients for rehabilitation after stroke and to examine the level of agreement
among physician assessors regarding admission to rehabilitation. DESIGN:
Questionnaire. SETTING: Health services with rehabilitation units in Victoria,
Australia. PARTICIPANTS: Rehabilitation unit physicians. MAIN OUTCOME : Questionnaire with 2 components : the clinical
and nonclinical factors that influence decision making and clinical case
scenarios. RESULTS: Responses were received from 17 physicians from 12 of the 18
health services in Victoria. The most influential clinical factors listed by the
respondents were prognosis, social supports, anticipated discharge destination,
age, and anticipated length of stay. Key nonclinical factors were prioritization
of internal health service referrals, patient's residence, and workforce
capacity. Analysis of the clinical scenarios of patients with severe stroke
showed that there was variability in the responses, with high levels of agreement
for some cases and low levels for others. Almost all respondents agreed that
prognosis was a key factor, yet, within the case scenarios, the reasons given for
accepting or not accepting the patient demonstrated different opinions on the
prognosis of the case presented. CONCLUSIONS: The decision-making processes in
selection for rehabilitation and the factors that influence that decision require
further investigation to optimize the use and outcomes from rehabilitation
resources.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS