Disparities in Postacute Stroke Rehabilitation Disposition to Acute Inpatient Rehabilitation vs. Home

Abstract

We evaluated the factors associated with discharge disposition to either inpatient rehabilitation or home after acute stroke hospitalization. We analyzed data from three concurrent years of State Hospital Discharge Data (years 2002-2004) of patients admitted with a primary International Classification of Diseases-9 code diagnosis of 430-434.9 and 436 (n = 7810). Logistic regression models tested whether discharge to inpatient rehabilitation vs. home was associated with socio-demographic factors. We controlled for covariates, including medical factors, such as number of intensive care unit days, Charlson Comorbidity Index, therapy charges, and available resources in their county. We found that older age, a greater number of intensive care unit days, higher total therapy charges, and lower poverty in their county of residence were associated with discharge to acute inpatient rehabilitation. Factors associated with discharge to home included younger age, fewer intensive care unit days, lower therapy charges, and higher poverty in their county of residence. Enabling factors, such as county poverty status and exposure to therapy may be important factors related to postacute stroke disposition.