Predicting long-term care institution utilization among post-rehabilitation stroke patients in Taiwan: a medical centre-based study

Purpose: Early identification of predictive factors relevant to the utiliza tion of long-term care institution for stroke patients is important and thu s investigated in this study on stroke patients receiving rehabilitation th erapy. Methods: This prospective follow-up investigation carried out during patien ts' clinical visits, at homes or long-term care institutions, was conducted at least 6 months after stroke on 151 stroke survivors. Functional ability was evaluated with the functional independence measure (FIM TM) instrument at discharge of the inpatient rehabilitation programme. Balance status was measured using the seven item balance scale of the Fugl-Meyer sensorimotor assessment (FMSA). Major medical, rehabilitative and sociodemographic fact ors were also examined during hospitalization period as independent variabl es. Results: Of all the patients surveyed, 23 (15.2%) had been living in long-t erm care institutions. Univariate statistical analysis indicated that the s ignificant factors related to longterm care institution utilization include d recurrence of attack, bilateral involvement, impaired orientation, and fu nctional and balance status at discharge. Conclusions: Basing on the significant predictors identified, analysis usin g the logistic regression model correctly classified three quarters of the subjects as long-term care institution residents. The strongest predictors of long-term care institution utilization for stroke patients following reh abilitation therapy were: bilaterally affected, impaired orientation and po or standing ability at discharge.