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T-Space at The University of Toronto Libraries >
Institute of Health Policy Management and Evaluation >
Walter Wodchis  >

Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/4762

Title: Skilled nursing facility rehabilitation and discharge to home following stroke
Authors: Wodchis, Walter P
Teare, Gary F
Naglie, Gary E
Bronskill, Susan
Gill, Sudeep S
Hillmer, Michael P
Anderson, Geoff M
Rochon, Paula A
Fries, Brant E
Keywords: Rehabilitation
Skilled Nursing Facilities
Nursing Home
Discharge Outcomes
Issue Date: Mar-2005
Publisher: Elsevier
Citation: Hillmer, M.P., Wodchis, W.P., Gill, S.S., Anderson, G.M., Rochon, P.A., Nursing home profit status and quality of care: Is there any evidence of an association? Medical Care Research and Review. 2005;62:139-166.
Abstract: Context: Rehabilitation therapy (RT) for stroke patients discharged from hospital is increasingly provided in skilled nursing facilities (SNF). Past studies suggest low effectiveness RT in these facilities. Objective: To determine the relationship between RT intensity and time to resident discharges home for stroke residents discharged from hospital to SNFs. Design: Retrospective cohort study. Hazard regression analyses were stratified by expected outcome and propensity score adjustment techniques were used. Setting: All SNFs in Ohio and Michigan, USA, and Ontario, Canada. Patients: A cohort of residents, aged 65 and over, admitted from hospital to SNF with a diagnosis of stroke (n=23,824). Main Outcome Measure: Time to discharge home from SNF. Results: RT was given to over 95% of residents for whom discharge was expected within 90 days and to over 60% of residents for whom discharge was uncertain or not expected. RT increased the likelihood of discharge to the community for all groups except those with a discharge expected within 30 days. The dose-response relationship was strongest for residents with either an uncertain discharge prognosis or no discharge expected. Conclusions: Post-acute residents with an uncertain prognosis are an important target population for intensive RT.
URI: http://hdl.handle.net/1807/4762
Appears in Collections:Walter Wodchis
Rochon, Paula

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