Characteristics of persons rehospitalized after stroke rehabilitation

Objective: To develop classification models for risk of hospital readmissio n 80 to 180 days after discharge based the demographic and functional chara cteristics of persons discharged from acute inpatient rehabilitation after stroke. Design: Retrospective, using information from US facilities subscribing to the Uniform Data System for Medical Rehabilitation (UDSMR). Setting: Information submitted to the UDSMR from 1994 through 1996 by 167 h ospital and rehabilitation facilities from 40 states was examined. Participants: A total of 15,992 records of patients (mean age +/- standard deviation, 70.97 +/- 12.19yr) with a diagnosis of stroke were included in t he final sample. The sample included 52.7% women and was 80% non-Hispanic w hite with an average length of stay (LOS) of 25.31 +/- 14.72 days. Interventions: Not applicable. Main Outcome Measures: Six subscales of the FIMTM instrument (self-care, sp inchter control, transfers, locomotion, communication, social cognition), t otal FIM, and other predictor variables for regression analysis (gender, ag e, ethnicity, marital status, prehospital living setting, LOS, primary paye r source, level of function-related group). Results: A logistic regression model included the following statistically s ignificant variables (p < .05): ethnicity, sphincter control, self-care abi lity, gender, and LOS. The greatest variability occurred among men. Exactly 18.1% of non-Hispanic white men and 17.9% of African-American men were reh ospitalized. In contrast, only 10.1% of Hispanic men and 11.4% of Asian men were rehospitalized. The odds of rehospitalization were lowest for Hispani c men. Conclusion: As prospective payment systems are introduced for postacute car e, it is important that the relationship among functional abilities, demogr aphic characteristics, and incidence of hospital readmission following medi cal rehabilitation be examined.