Older Age, Low Socioeconomic Status, and Multiple Comorbidities Lower the Probability of Receiving Inpatient Rehabilitation Half a Year After Stroke

All stroke survivors should be able to receive and use stroke protocols that get them to 100% recovery. No stroke survivor left behind. If you can't get behind that goal then get the fuck out of the stroke profession. 
http://www.archives-pmr.org/article/S0003-9993%2816%2930960-1/fulltext#.WZLrX54sH00.twitter

Huan-Jui Yeh, MD

,

Nicole Huang, PhD

,

Yiing-Jenq Chou, PhD

,

Shun-Ping Cheng, MD

,

Wai-Keung Lee, MD

,

Chun-Cho Lai, MD

,

Chi-Chia Cheng, MDCorrespondence information about the author MD Chi-Chia ChengEmail the author MD Chi-Chia Cheng

Older Age, Low Socioeconomic Status, and Multiple Comorbidities Lower the Probability of Receiving Inpatient Rehabilitation Half a Year After Stroke

DOI: http://dx.doi.org/10.1016/j.apmr.2016.08.468

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Abstract

Objective

To determine the predictors of receiving inpatient rehabilitation during 7 to 12 months after stroke.

Design

Retrospective cohort study.

Setting

A nationally representative sample of 1 million National Health Insurance enrollees.

Participants

Patients with new-onset stroke (N=13,828) were included. Studied participants were patients who received inpatient rehabilitation during 4 to 6 months after stroke. Patients who died within 1 year of the stroke event were excluded (n=488).

Interventions

Not applicable.

Main Outcome Measures

The outcome variable of interest was the probability of receiving inpatient rehabilitation during 7 to 12 months after stroke. The characteristics of both patients and medical care providers were investigated to determine their effect on patients receiving inpatient rehabilitation.

Results

Older patients, patients of low socioeconomic status, patients with Charlson Comorbidity Index ≥5, and patients who received outpatient rehabilitation during 4 to 6 months after stroke have a lower rate of receiving inpatient rehabilitation than do their counterparts. In addition, receiving inpatient rehabilitation during 7 to 9 months after stroke is a strong positive predictor of receiving inpatient rehabilitation during 10 to 12 months after stroke (odds ratio, 38.556; P<.0001).

Conclusions

This study revealed that older age, lower socioeconomic status, and multiple comorbidities are negative predictive factors with a cumulative predictive power for the probability of receiving inpatient rehabilitation during 7 to 12 months after stroke.