TY - JOUR
T1 - Assessing stroke patients for rehabilitation during the acute hospitalization
T2 - Findings from the get with the guidelines-stroke program
AU - Prvu Bettger, Janet A.
AU - Kaltenbach, Lisa
AU - Reeves, Mathew J.
AU - Smith, Eric E.
AU - Fonarow, Gregg C.
AU - Schwamm, Lee H.
AU - Peterson, Eric D.
N1 - Funding Information:
Supported in part by an Agency for Healthcare Research and Quality Mentored Scholar in Comparative Effectiveness Research training grant awarded to Duke University (grant no. K12HS019479 ). The Get With The Guidelines–Stroke (GWTG-Stroke) program is currently supported in part by a charitable contribution from Janssen Pharmaceutical Companies of Johnson & Johnson . GWTG-Stroke has been funded in the past through support from Boehringer-Ingelheim, Merck, Bristol-Myers Squibb/Sanofi Pharmaceutical Partnership, and the AHA Pharmaceutical Roundtable. These organizations did not and do not participate in the design, analysis, manuscript preparation, or approval.
PY - 2013/1
Y1 - 2013/1
N2 - Objective: To examine the frequency and determinants of an assessment for rehabilitation during the hospitalization for acute stroke. Design: Prospective cohort of patients admitted with acute stroke in the Get With The Guidelines-Stroke (GWTG-Stroke) program from January 8, 2008, to March 31, 2011. Setting: Acute hospitals (n=1532) in the United States participating in the GWTG-Stroke program. Participants: Adults with a stroke diagnosis (N=616,982) from a GWTG-Stroke-participating acute hospital. Interventions: Not applicable. Main Outcome Measure: Documentation of an assessment for rehabilitation services during the acute hospitalization. Results: Overall, almost 90% of stroke patients had documentation of an acute assessment for rehabilitation. In multivariable analysis, patients significantly more likely to be assessed for rehabilitation were younger, male, black or of other nonwhite races (Asian, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander) when compared with white, independently ambulating before admission, and admitted from the community. Patients who received a stroke consult, cared for in a stroke unit, and treated in the northeast region of the United States were also more likely to be assessed. Conclusions: There is evidence that rehabilitation was considered for 90% of acute stroke patients in this sample. Future research is needed to examine what assessments are conducted and by whom, and how these are used to determine the appropriate level of rehabilitation care for their needs.
AB - Objective: To examine the frequency and determinants of an assessment for rehabilitation during the hospitalization for acute stroke. Design: Prospective cohort of patients admitted with acute stroke in the Get With The Guidelines-Stroke (GWTG-Stroke) program from January 8, 2008, to March 31, 2011. Setting: Acute hospitals (n=1532) in the United States participating in the GWTG-Stroke program. Participants: Adults with a stroke diagnosis (N=616,982) from a GWTG-Stroke-participating acute hospital. Interventions: Not applicable. Main Outcome Measure: Documentation of an assessment for rehabilitation services during the acute hospitalization. Results: Overall, almost 90% of stroke patients had documentation of an acute assessment for rehabilitation. In multivariable analysis, patients significantly more likely to be assessed for rehabilitation were younger, male, black or of other nonwhite races (Asian, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander) when compared with white, independently ambulating before admission, and admitted from the community. Patients who received a stroke consult, cared for in a stroke unit, and treated in the northeast region of the United States were also more likely to be assessed. Conclusions: There is evidence that rehabilitation was considered for 90% of acute stroke patients in this sample. Future research is needed to examine what assessments are conducted and by whom, and how these are used to determine the appropriate level of rehabilitation care for their needs.
KW - Quality of health care
KW - Rehabilitation
KW - Stroke
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U2 - 10.1016/j.apmr.2012.06.029
DO - 10.1016/j.apmr.2012.06.029
M3 - Article
C2 - 22858797
AN - SCOPUS:84871608558
SN - 0003-9993
VL - 94
SP - 38
EP - 45
JO - Archives of physical medicine and rehabilitation
JF - Archives of physical medicine and rehabilitation
IS - 1
ER -