Factors related to home discharge of cerebrovascular disease patients: 1-year follow-up interview survey of caregivers of hospitalized patients in 53acute care hospitals in Japan

In Japan, many disabled elderly people remain hospitalized for long periods . Cerebrovascular diseases (CVD) are the most causes responsible for such d isability. To examine the predictors of home discharge in CVD patients, we performed a 1-year follow-up interview of the main caregivers of patients h ospitalized with a CVD event, The initial cohort consisted of CVD patients hospitalized in all the second level emergency and general hospitals in lba raki Prefecture in February 1992 (N = 888 patients in 53 hospitals). In the following year, we performed an interview survey of the main caregivers of these CVD patients. The survey items included the characteristics of the p atients (including medical and socioeconomic conditions), caregivers, and f amily members. The final study population included the main caregivers of 1 87 home patients and 90 institutionalized patients. We compared these two g roups in terms of predictors of discharge to home. The results Of Multiple logistic regression analysis showed that the following seven factors were r elated to home discharge; better baseline activities of daily living (ADL), larger improvement in ADL, larger family size, spouse as the caregiver, ca regiver without a full-time job, better economic status of the caregiver, a nd sources of the patient's income. Our study indicated that the caregiver' s conditions were closely related to home discharge of the CVD patients. Mo re attention should, therefore, be centered on the caregiver's well-being a nd economic aspects as well as the patient's conditions in order to encoura ge home discharge of stroke patients. (C) 2001 Elsevier Science Ireland Ltd . All rights reserved.