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.

Tuesday, May 17, 2016

Patient- and Hospital-Level Determinants of Rehabilitation for In-Patient Stroke Care: An Observation Analysis

No clue what the point of this research was.
http://journals.lww.com/md-journal/Fulltext/2016/05100/Patient__and_Hospital_Level_Determinants_of.50.aspx
Medicine:
doi: 10.1097/MD.0000000000003620
Research Article: Observational Study
 

Chen, Tsung-Tai PhD; Chen, Chia-Pei RN, MS; Kuang, Shao-Hua MS; Wang, Vinchi MD, PhD
Section Editor(s): Gopichandran., Vijayaprasad

Open Access
Supplemental Author Material
Article Outline

Author Information

From the Department of Public Health (TTC), School of Medicine (VW), College of Medicine, Fu-Jen Catholic University, and Neurological Center, Cardinal Tien Hospital, New Taipei City, Taiwan (VW), Medical Quality Management Center, Nursing Department, Cardinal Tien Hospital, and College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan (CPC), Medical Affairs Office, Cardinal Tien Hospital (SHK).
Correspondence: Vinchi Wang, Neurological Center, Cardinal Tien Hospital, 362, Zhongzheng Road, Xindian District, New Taipei City 231, Taiwan (e-mail: vwneur@yahoo.com.tw).
Abbreviations: AIC = Akaike Information Criterion, CI = cerebral infarction, ECM = Elixhauser Comorbidity Measures, GLMM = generalized linear mixed model, HHI = Herfindahl–Hirschman Index, ICC = intraclass correlation coefficient, ICH = intracranial hemorrhage, NHIA = National Health Insurance Administration, PCV = proportional change in variance.
This study was supported by grants from the Cardinal Tien Hospital (CTH-103-1-2B05) in Taiwan.
The authors have no conflicts of interest to disclose.
Supplemental Digital Content is available for this article.
Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.md-journal.com).
This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0, where it is permissible to download, share and reproduce the work in any medium, provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0

Abstract

Abstract: During acute stroke care, rehabilitation usage may be influenced by patient- and hospital-related factors. We would like to identify patient- and hospital-level determinants of population-level inpatient rehabilitation usage associated with acute stroke care.
From data obtained from the claim information from the National Health Insurance Administration (NHIA) in Taiwan (2009–2011), we enrolled 82,886 stroke patients with intracerebral hemorrhage and cerebral infarction from 207 hospitals. A generalized linear mixed model (GLMM) analyses with patient-level factors specified as random effects were conducted (for cross-level interactions).
The rate of rehabilitation usage was 51% during acute stroke care. The hospital-related factors accounted for a significant amount of variability (intraclass correlation, 50%). Hospital type was the only significant hospital-level variable and can explain the large amount of variability (58%). Patients treated in smaller hospitals experienced few benefits of rehabilitation services, and those with surgery in a smaller hospital used fewer rehabilitation services. All patient-level variables were significant.
With GLMM analyses, we identified the hospital type and its cross-level interaction, and explained a large portion of variability in rehabilitation for stroke patients in Taiwan.

 

No comments:

Post a Comment