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Predicting long-term care institution utilization among post-rehabilitation stroke patients in Taiwan: a medical
J H Lin1, C L Hsieh, S F Hsiao
1Division of Physical Therapy, School of Rehabilitation Medicine, Kaohsiung Medical University, Taiwan. ljh@mail.rm.kmu.edu.tw
Purpose:
Early identification of predictive factors relevant to the utilization of long-term care institution for stroke patients is important and thus investigated in this study on stroke patients receiving rehabilitation therapy.
Methods:
This prospective follow-up investigation carried out during patients' clinical visits, at homes or long-term care institutions, was conducted at least 6 months after stroke on 151 stroke survivors. Functional ability was evaluated with the functional independence measure (FIM) instrument at discharge of the inpatient rehabilitation programme. Balance status was measured using the seven item balance scale of the Fugl-Meyer sensorimotor assessment (FMSA). Major medical, rehabilitative and sociodemographic factors were also examined during hospitalization period as independent variables.
Results:
Of all the patients surveyed, 23 (15.2%) had been living in long-term care institutions. Univariate statistical analysis indicated that the significant factors related to long-term care institution utilization included recurrence of attack, bilateral involvement, impaired orientation, and functional and balance status at discharge.
Conclusions:
Basing on the significant predictors identified, analysis using the logistic regression model correctly classified three quarters of the subjects as long-term care institution residents. The strongest predictors of long-term care institution utilization for stroke patients following rehabilitation therapy were: bilaterally affected, impaired orientation and poor standing ability at discharge.