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Trends in outpatient rehabilitation use for stroke survivors

Published:August 17, 2022DOI:https://doi.org/10.1016/j.jns.2022.120383

      Highlights

      • Utilization of outpatient rehabilitation is an expanding healthcare resource in stroke patients.
      • The trend in outpatient utilization for stroke recovery was not influenced by patient insurance type.
      • Over time, there was no gender bias in outpatient rehabilitation utilization in stroke survivors.

      Abstract

      Background

      Stroke survivors with residual disabling deficits who are medically stable may be recommended for acute rehabilitation or outpatient therapy, depending partly on the severity of their deficits. Here we sought to determine if the location at which patients needing rehabilitation post-stroke has shifted from inpatient to an outpatient setting.

      Methods

      For analysis, we used our Institutional Review Board-approved Get With The Guidelines®-Stroke Database to study stroke survivors discharged to receive either inpatient or outpatient rehabilitation services between 2014 and 2019. Logistic regression analysis was used to identify clinical factors associated with discharge type. Cochran-Armitage trend analysis was used to assess differences in rehabilitation services used over time.

      Results

      A total of 3293 patients were included. Trend analysis demonstrated a significant increase over time in the proportion of patients needing rehabilitation being discharged home with rehabilitation services (P < 0.0001). In addition, older age was associated with discharge to inpatient rehabilitation (OR = 1.018, 95%CI, 1.011–1.026), as was a higher National Institutes of Health Stroke Scale score (OR = 1.149, 95%CI, 1.130–1.168).

      Conclusions

      We found that home discharges increased, highlighting outpatient rehabilitation as an expanding healthcare resource for reducing stroke-associated disability in adults.

      Keywords

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