Research Activities, July 2013
Most stroke patients are assessed for rehabilitation during their initial hospitalization
Rehabilitation is the key to functional recovery and psychological adjustment for patients who have suffered a stroke. In fact, stroke survivors have been found to do better when treated in a facility where they can receive coordinated, multidisciplinary, stroke-related evaluation and rehabilitation services. A new study found that nearly 90 percent of acute stroke patients enrolled in a registry of stroke patients from 1,532 acute hospitals in the United States had an assessment for rehabilitation services documented in their medical record.
The researchers used data from the stroke registry for patients admitted to a participating hospital during the 3-year study period to determine whether the patient's record included any of six indications of evaluation for rehabilitation. Patients with an assessment were likely to be younger (decreasing by 16 percent for each 10-year increase in age). They were also 11 percent more likely to be male, more likely to be black (by 38 percent) or Asian (by 5 percent) than white, and more likely to have Medicare or Medicaid (by 7 percent or 8 percent, respectively) than private or Veterans Administration insurance. Patients who had a stroke while in a rehabilitation or long-term-care facility were 55 percent less likely to have an evaluation, but patients with longer hospital stays were 3 percent more likely and those who received care in a stroke unit were 38 percent more likely to be assessed for rehabilitation.
The findings were based on analysis of data on patients in the American Heart Association's Get With the Guidelines—Stroke national registry and performance improvement initiative from January 1, 2008, through March 31, 2011. The study was funded in part by AHRQ (HS19479).
More details are in "Assessing stroke patients for rehabilitation during the acute hospitalization: Findings from the Get With the Guidelines—Stroke Program," by Janet A. Prvu Bettger, Sc.D., Lisa Kaltenbach, M.S., Mathew J. Reeves, Ph.D., and others in the January 2013 Archives of Physical Medicine and Rehabilitation 94(1), pp. 38–45.