Socio-environmental predictive factors for discharge destination after inpatient rehabilitation in patients with stroke: a systematic review and meta-analysis

If your hospital is having to search for these factors it means your hospital has completely failed at getting you 100% recovered.  That requires a call to the president asking what the goals are for the stroke department. Anything less than 100% recovery means the whole department needs to be rebuilt and start over. 

 Socio-environmental predictive factors for discharge destination after inpatient rehabilitation in patients with stroke: a systematic review and meta-analysis

Abstract 

Purpose

To identify which of the socio-environmental factors of patients with stroke are predictive for discharge to their home after inpatient rehabilitation. Because discharge planning is a key component of rehabilitation, it is important to recognize the predictive factors for a discharge home. Other systematic reviews demonstrated the value of functional outcome measures. This review adds to the current literature by assessing the predictive value of socio-environmental factors, which shape the context in which a person lives. We performed a systematic search in seven databases. Two independent reviewers selected studies and assessed them for methodological quality. We extracted data to estimate pooled odds ratio for household situation, social support, ethnicity and socioeconomic status.Forty studies were included. Significant estimates were found for living with others (OR 2.60; 95%CI 1.84–3.68), having support at home (OR 11.48; 95%CI 6.52–20.21), being married (OR 2.05; 95%CI 1.80–2.33) and living at home before stroke (OR 31.01; 95%CI 7.38–130.18).Living at home and benefiting from social support, including living with others, are important factors to consider during discharge planning after stroke. Further research should consider the impact of socioeconomic status. 

Methods

We performed a systematic search in seven databases. Two independent reviewers selected studies and assessed them for methodological quality. We extracted data to estimate pooled odds ratio for household situation, social support, ethnicity and socioeconomic status.

Results

Forty studies were included. Significant estimates were found for living with others (OR 2.60; 95%CI 1.84–3.68), having support at home (OR 11.48; 95%CI 6.52–20.21), being married (OR 2.05; 95%CI 1.80–2.33) and living at home before stroke (OR 31.01; 95%CI 7.38–130.18).

Conclusion

Living at home and benefiting from social support, including living with others, are important factors to consider during discharge planning after stroke. Further research should consider the impact of socioeconomic status.

IMPLICATIONS FOR REHABILITATION 

Evaluating the social and environmental factors of patients with stroke plays an important role in discharge planning.Next to functional status, caregiver availability (support at home) is among the strongest predictive factors for discharge home.To assess caregiver availability, the presence of a willing and able caregiver should be surveyed at admission.Further predictive factors for discharge home are cohabitation and marital status.