Using the Functional Independence Measure instrument to predict stroke rehabilitation outcomes

The purpose of the study described in this article was to identify the factors that have an impact on stroke patients' discharge destination. Two hundred thirty-four stroke patients admitted to a rehabilitation facility over a 2-year period were examined. Functional Independence Measure (FIM) data were used to examine functional status, demographic characteristics, and the discharge destination of patients admitted to the facility's program. The relationship between patients' FIM scores at discharge and their discharge locations was analyzed using the chi-square statistic. The results showed that a discharge FIM score of 80 or above had a high specificity and sensitivity with patients' discharge to their homes. In addition, outliers were analyzed, and the results showed that family members of only 20% of the patients who were discharged to their homes were working, in contrast to 65% of the family members of patients who were discharged to a skilled nursing facility. The availability of a nonworking family member and the ability of a family to provide supervision and physical assistance were more likely to be factors related to discharge of patients to their homes. Ninety percent of the families of patients discharged to their homes were able to provide supervision and to provide physical assistance. Thus, both functional status and social factors, such as family availability and support, are critical elements in predicting the discharge destination of this patient population.