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|Title: ||Skilled nursing facility rehabilitation and discharge to home following stroke
|Authors: ||Wodchis, Walter P|
Teare, Gary F
Naglie, Gary E
Gill, Sudeep S
Hillmer, Michael P
Anderson, Geoff M
Rochon, Paula A
Fries, Brant E
Skilled Nursing Facilities
|Issue Date: ||Mar-2005|
|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.
|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.|
|Appears in Collections:||Walter Wodchis |
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