Predictors of resource use after acute hospitalization

The Northern Manhattan Stroke Study

Tanja Rundek, H. Mast, A. Hartmann, B. Boden-Albala, L. Lennihan, I. F. Lin, M. C. Paik, R. L. Sacco

Research output: Contribution to journalArticle

Abstract

Objective: To determine demographic and clinical predictors of discharge destinations following acute care hospitalization for stroke in the community of northern Manhattan. Methods: A group of 893 patients (mean age, 70 ± 12 years; 56% women; 51% Hispanic, 30% African-American, 19% white) who survived acute care hospitalization for a first ischemic stroke were followed prospectively. Stroke severity was assessed by the NIH Stroke Scale and categorized as mild (≤5), moderate (6 to 13), and severe (≥14). Polytomous logistic regression was used to determine predictors for rehabilitation and nursing home placement versus returning home. Results: Among the survivors of acute stroke care hospitalization, 611 (68%) patients were discharged to their homes, 168 (19%) to rehabilitation, and 114 (13%) to nursing homes. Patients with moderate and severe neurologic deficits had more than a threefold increased risk of being sent to a nursing home and more than an eightfold increased risk of being sent to rehabilitation. Age over 65 and cognitive impairment were associated with placement to a nursing home (age over 65: OR, 2.4; 95% CI, 1.0 to 5.6; cognitive impairment: OR, 2.9; 95%, CI 1.4 to 5.7), and rehabilitation (age over 65: OR, 1.8; 95% CI, 1.1 to 2.9; cognitive impairment: OR, 2.9; 95% CI, 1.4 to 5.7). Conclusion: Our results demonstrated that one-third of patients with acute stroke from the community of northern Manhattan required placement in a temporary or a long-term disability care institution following acute care hospitalization. Severity of stroke is an important factor that influences discharge planning following acute care hospitalization and its reduction can improve health care resource usage.

Original languageEnglish (US)
Pages (from-to)1180-1187
Number of pages8
JournalNeurology
Volume55
Issue number8
StatePublished - Oct 24 2000

Fingerprint

Hospitalization
Stroke
Nursing Homes
Rehabilitation
Rehabilitation Nursing
Patient Discharge
Health Resources
Long-Term Care
Neurologic Manifestations
Hispanic Americans
African Americans
Survivors
Logistic Models
Demography
Delivery of Health Care
Cognitive Dysfunction

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Rundek, T., Mast, H., Hartmann, A., Boden-Albala, B., Lennihan, L., Lin, I. F., ... Sacco, R. L. (2000). Predictors of resource use after acute hospitalization: The Northern Manhattan Stroke Study. Neurology, 55(8), 1180-1187.

Predictors of resource use after acute hospitalization : The Northern Manhattan Stroke Study. / Rundek, Tanja; Mast, H.; Hartmann, A.; Boden-Albala, B.; Lennihan, L.; Lin, I. F.; Paik, M. C.; Sacco, R. L.

In: Neurology, Vol. 55, No. 8, 24.10.2000, p. 1180-1187.

Research output: Contribution to journalArticle

Rundek, T, Mast, H, Hartmann, A, Boden-Albala, B, Lennihan, L, Lin, IF, Paik, MC & Sacco, RL 2000, 'Predictors of resource use after acute hospitalization: The Northern Manhattan Stroke Study', Neurology, vol. 55, no. 8, pp. 1180-1187.
Rundek T, Mast H, Hartmann A, Boden-Albala B, Lennihan L, Lin IF et al. Predictors of resource use after acute hospitalization: The Northern Manhattan Stroke Study. Neurology. 2000 Oct 24;55(8):1180-1187.
Rundek, Tanja ; Mast, H. ; Hartmann, A. ; Boden-Albala, B. ; Lennihan, L. ; Lin, I. F. ; Paik, M. C. ; Sacco, R. L. / Predictors of resource use after acute hospitalization : The Northern Manhattan Stroke Study. In: Neurology. 2000 ; Vol. 55, No. 8. pp. 1180-1187.
@article{8f1e4f297657477c88f1fe7d1a4b01c9,
title = "Predictors of resource use after acute hospitalization: The Northern Manhattan Stroke Study",
abstract = "Objective: To determine demographic and clinical predictors of discharge destinations following acute care hospitalization for stroke in the community of northern Manhattan. Methods: A group of 893 patients (mean age, 70 ± 12 years; 56{\%} women; 51{\%} Hispanic, 30{\%} African-American, 19{\%} white) who survived acute care hospitalization for a first ischemic stroke were followed prospectively. Stroke severity was assessed by the NIH Stroke Scale and categorized as mild (≤5), moderate (6 to 13), and severe (≥14). Polytomous logistic regression was used to determine predictors for rehabilitation and nursing home placement versus returning home. Results: Among the survivors of acute stroke care hospitalization, 611 (68{\%}) patients were discharged to their homes, 168 (19{\%}) to rehabilitation, and 114 (13{\%}) to nursing homes. Patients with moderate and severe neurologic deficits had more than a threefold increased risk of being sent to a nursing home and more than an eightfold increased risk of being sent to rehabilitation. Age over 65 and cognitive impairment were associated with placement to a nursing home (age over 65: OR, 2.4; 95{\%} CI, 1.0 to 5.6; cognitive impairment: OR, 2.9; 95{\%}, CI 1.4 to 5.7), and rehabilitation (age over 65: OR, 1.8; 95{\%} CI, 1.1 to 2.9; cognitive impairment: OR, 2.9; 95{\%} CI, 1.4 to 5.7). Conclusion: Our results demonstrated that one-third of patients with acute stroke from the community of northern Manhattan required placement in a temporary or a long-term disability care institution following acute care hospitalization. Severity of stroke is an important factor that influences discharge planning following acute care hospitalization and its reduction can improve health care resource usage.",
author = "Tanja Rundek and H. Mast and A. Hartmann and B. Boden-Albala and L. Lennihan and Lin, {I. F.} and Paik, {M. C.} and Sacco, {R. L.}",
year = "2000",
month = "10",
day = "24",
language = "English (US)",
volume = "55",
pages = "1180--1187",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "8",

}

TY - JOUR

T1 - Predictors of resource use after acute hospitalization

T2 - The Northern Manhattan Stroke Study

AU - Rundek, Tanja

AU - Mast, H.

AU - Hartmann, A.

AU - Boden-Albala, B.

AU - Lennihan, L.

AU - Lin, I. F.

AU - Paik, M. C.

AU - Sacco, R. L.

PY - 2000/10/24

Y1 - 2000/10/24

N2 - Objective: To determine demographic and clinical predictors of discharge destinations following acute care hospitalization for stroke in the community of northern Manhattan. Methods: A group of 893 patients (mean age, 70 ± 12 years; 56% women; 51% Hispanic, 30% African-American, 19% white) who survived acute care hospitalization for a first ischemic stroke were followed prospectively. Stroke severity was assessed by the NIH Stroke Scale and categorized as mild (≤5), moderate (6 to 13), and severe (≥14). Polytomous logistic regression was used to determine predictors for rehabilitation and nursing home placement versus returning home. Results: Among the survivors of acute stroke care hospitalization, 611 (68%) patients were discharged to their homes, 168 (19%) to rehabilitation, and 114 (13%) to nursing homes. Patients with moderate and severe neurologic deficits had more than a threefold increased risk of being sent to a nursing home and more than an eightfold increased risk of being sent to rehabilitation. Age over 65 and cognitive impairment were associated with placement to a nursing home (age over 65: OR, 2.4; 95% CI, 1.0 to 5.6; cognitive impairment: OR, 2.9; 95%, CI 1.4 to 5.7), and rehabilitation (age over 65: OR, 1.8; 95% CI, 1.1 to 2.9; cognitive impairment: OR, 2.9; 95% CI, 1.4 to 5.7). Conclusion: Our results demonstrated that one-third of patients with acute stroke from the community of northern Manhattan required placement in a temporary or a long-term disability care institution following acute care hospitalization. Severity of stroke is an important factor that influences discharge planning following acute care hospitalization and its reduction can improve health care resource usage.

AB - Objective: To determine demographic and clinical predictors of discharge destinations following acute care hospitalization for stroke in the community of northern Manhattan. Methods: A group of 893 patients (mean age, 70 ± 12 years; 56% women; 51% Hispanic, 30% African-American, 19% white) who survived acute care hospitalization for a first ischemic stroke were followed prospectively. Stroke severity was assessed by the NIH Stroke Scale and categorized as mild (≤5), moderate (6 to 13), and severe (≥14). Polytomous logistic regression was used to determine predictors for rehabilitation and nursing home placement versus returning home. Results: Among the survivors of acute stroke care hospitalization, 611 (68%) patients were discharged to their homes, 168 (19%) to rehabilitation, and 114 (13%) to nursing homes. Patients with moderate and severe neurologic deficits had more than a threefold increased risk of being sent to a nursing home and more than an eightfold increased risk of being sent to rehabilitation. Age over 65 and cognitive impairment were associated with placement to a nursing home (age over 65: OR, 2.4; 95% CI, 1.0 to 5.6; cognitive impairment: OR, 2.9; 95%, CI 1.4 to 5.7), and rehabilitation (age over 65: OR, 1.8; 95% CI, 1.1 to 2.9; cognitive impairment: OR, 2.9; 95% CI, 1.4 to 5.7). Conclusion: Our results demonstrated that one-third of patients with acute stroke from the community of northern Manhattan required placement in a temporary or a long-term disability care institution following acute care hospitalization. Severity of stroke is an important factor that influences discharge planning following acute care hospitalization and its reduction can improve health care resource usage.

UR - http://www.scopus.com/inward/record.url?scp=0034711131&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034711131&partnerID=8YFLogxK

M3 - Article

VL - 55

SP - 1180

EP - 1187

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 8

ER -