Article

OBJECTIVE: To determine which patient-, treatment-, and facility-level
characteristics were associated with home discharge among patients hospitalized
for stroke within the Department of Veterans Affairs.
DESIGN: Retrospective
observational study. SETTING: Veterans Affairs facilities nationwide.
PARTICIPANTS: Veterans hospitalized for stroke during fiscal year 2007 to fiscal
year 2008 (N=12,565). INTERVENTION: Not applicable. MAIN OUTCOME MEASURE:
Discharge location after hospitalization. RESULTS: There were 10,130 (80.6%)
veterans discharged home after hospitalization for acute stroke. Married veterans
were more likely than nonmarried veterans to be discharged home (odds ratio
[OR]=1.23; 95% confidence interval [CI]=1.11-1.35). Compared with veterans
admitted to the hospital from home, patients admitted from extended care were
less likely to be discharged home (OR=.04; 95% CI=.03-.07). Compared with those
with occlusion of cerebral arteries, patients with intracerebral hemorrhage
(OR=.61; 95% CI=.50-.74) or other central nervous system hemorrhage (OR=.78; 95%
CI=.63-.96) were less likely to be discharged home, whereas patients with
occlusion of precerebral arteries (OR=1.36; 95% CI=1.07-1.73) were more likely to
return home. Evidence of congestive heart failure (OR=.85; 95% CI=.76-.95), fluid
and electrolyte disorders (OR=.86; 95% CI=.77-.96), internal organ procedures and
diagnostics (OR=.87; 95% CI=.78-.97), and serious nutritional compromise (OR=.49;
95% CI=.40-.62) during hospitalization remained independently associated with
lower odds of home discharge. Longer hospitalizations and receipt of
rehabilitation services while hospitalized acutely were negatively associated,
whereas treatment on more bed sections and rehabilitation accreditation of the
facility were positively associated with home discharge. Region exerted a
statistically significant effect on home discharge. CONCLUSIONS: We found
sociological, clinical, and facility-level factors associated with home discharge
after hospitalization for acute stroke. Findings document the importance of
considering a broad range of characteristics rather than focusing only on a few
specific traits during discharge planning.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS