Characteristics of persons rehospitalized after stroke rehabilitation

Objective: To develop classification models for risk of hospital readmission 80 to 180 days after discharge based the demographic and functional characteristics 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 hospital 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 the final sample. The sample included 52.7% women and was 80% non-Hispanic white 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, spinchter control, transfers, locomotion, communication, social cognition), total FIM, and other predictor variables for regression analysis (gender, age, ethnicity, marital status, prehospital living setting, LOS, primary payer source, level of function-related group). Results: A logistic regression model included the following statistically significant variables (p < .05): ethnicity, sphincter control, self-care ability, 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 rehospitalized. In contrast, only 10.1% of Hispanic men and 11.4% of Asian men were rehospitalized. The odds of rehospitalization were lowest for Hispanic men. Conclusion: As prospective payment systems are introduced for postacute care, it is important that the relationship among functional abilities, demographic characteristics, and incidence of hospital readmission following medical rehabilitation be examined.