Deans' stroke musings: Regional Variation in Stroke Rehabilitation Outcomes

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, August 7, 2013

Regional Variation in Stroke Rehabilitation Outcomes

Where do you fall in outcomes compared to these 143,036 people? Your doctor should be using that as a baseline to determine how good their hospital is in getting patients back to recovery. A great or even good stroke association should be keeping this data as a running total so changes over the years can be measured. But, alas we have no 'good' stroke association. We don't have any stroke association worthy of the name.
http://www.sciencedirect.com/science/article/pii/S0003999313005832

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Abstract

Objective

To examine and describe regional variation in outcomes for persons with stroke receiving inpatient medical rehabilitation.

Design

Retrospective cohort design.

Setting

Inpatient rehabilitation units and facilities contributing to the Uniform Data System for Medical Rehabilitation (UDSMR) from the United States.

Participants

143,036 patients with stroke discharged from inpatient rehabilitation during 2006 and 2007.

Interventions

Not applicable.

Main Outcome Measures

Community discharge, length of stay, discharge functional status ratings (motor, cognitive), across ten geographic service regions defined by the Centers for Medicare and Medicaid Services (CMS).

Results

Approximately 71% of the sample was discharged to the community. After adjusting for covariates, the percentage discharged to the community varied from 79.1% in the southwest (CMS 9) to 59.4% in the northeast (CMS 2). Adjusted length of stay varied by 2.1 days with CMS 1 having the longest length of stay at 18.3 days and CMS 5 and 9 being the shortest at 16.2 days.

Conclusion

Rehabilitation outcomes for persons with stroke varied across CMS regions. Substantial variation in discharge destination and length of stay remained after adjusting for demographic and clinical characteristics.

Deans' stroke musings