TY - JOUR
T1 - Social determinants of discharge destination for patients after stroke with low admission FIM instrument scores
AU - Nguyen, Tuan-Anh
AU - Page, Andrew
AU - Aggarwal, Arun
AU - Henke, Peter
PY - 2007
Y1 - 2007
N2 - Objective: To investigate the effects of immigrant status (via country of birth), marital status, and area-based socioeconomic status (SES) on discharge destination after stroke for those with low admission scores on the FIM instrument. Design: Cross-sectional study. Setting: Inpatient rehabilitation ward at an urban community hospital in Australia. Participants: A total of 326 inpatients admitted for rehabilitation poststroke. Intervention: Multidisciplinary rehabilitation. Main Outcome Measure: Discharge home versus nursing home. Results: A total admission FIM score of 75 or lower was associated with a higher probability of nursing home discharge. Married patients with a total FIM admission score of 75 or lower were significantly more likely to be discharged home, after adjusting for immigrant status, type and side of stroke, sex, and age (odds ratio, 6.07; 95% confidence interval, 1.65–22.40; P<.01). This effect was also observed for low motor and cognition components of FIM admission score. The effect of immigrant status did not remain significant after adjusting for marital status. Area-based SES and stroke characteristics did not substantially attenuate the relationship between immigrant status, marital status, and discharge location. Conclusions: Marital status is a significant determinant of discharge destination. Immigrant status and area-based SES were not significant predictors of discharge disposition.
AB - Objective: To investigate the effects of immigrant status (via country of birth), marital status, and area-based socioeconomic status (SES) on discharge destination after stroke for those with low admission scores on the FIM instrument. Design: Cross-sectional study. Setting: Inpatient rehabilitation ward at an urban community hospital in Australia. Participants: A total of 326 inpatients admitted for rehabilitation poststroke. Intervention: Multidisciplinary rehabilitation. Main Outcome Measure: Discharge home versus nursing home. Results: A total admission FIM score of 75 or lower was associated with a higher probability of nursing home discharge. Married patients with a total FIM admission score of 75 or lower were significantly more likely to be discharged home, after adjusting for immigrant status, type and side of stroke, sex, and age (odds ratio, 6.07; 95% confidence interval, 1.65–22.40; P<.01). This effect was also observed for low motor and cognition components of FIM admission score. The effect of immigrant status did not remain significant after adjusting for marital status. Area-based SES and stroke characteristics did not substantially attenuate the relationship between immigrant status, marital status, and discharge location. Conclusions: Marital status is a significant determinant of discharge destination. Immigrant status and area-based SES were not significant predictors of discharge disposition.
KW - stroke
KW - rehabilitation
KW - emigration and immigration
KW - marriage
UR - http://handle.uws.edu.au:8081/1959.7/526073
U2 - 10.1016/j.apmr.2007.03.011
DO - 10.1016/j.apmr.2007.03.011
M3 - Article
SN - 0003-9993
VL - 88
SP - 740
EP - 744
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 6
ER -
