Is the Activity Measure for Postacute Care "6-Clicks" Tool Associated With Discharge Destination Postacute Stroke?

Area of Science:

• Neurology
• Rehabilitation Medicine
• Health Services Research

Background:

• Stroke significantly impacts physical function, influencing discharge disposition and postacute care needs.
• Accurate prediction of discharge destination is crucial for resource allocation and patient-centered care planning.

Purpose of the Study:

• To examine the association between early post-stroke physical function, measured by the Activity Measure for Postacute Care (AM-PAC) Inpatient "6-Clicks" scores, and discharge destination.
• To determine if AM-PAC scores can differentiate between discharge to home versus a facility, and between inpatient rehabilitation facilities (IRF) and skilled nursing facilities (SNF).

Main Methods:

• Retrospective cross-sectional cohort study of 721 individuals post acute ischemic stroke.
• Utilized AM-PAC "6-Clicks" scores from 3 domains (basic mobility, daily activity, applied cognition) measured within 24 hours of hospital discharge.
• Discharge destinations analyzed included home, IRF, and SNF.

Main Results:

• AM-PAC basic mobility and daily activity scores were significant predictors of discharge to home versus a facility.
• Individuals discharged home had significantly higher AM-PAC basic mobility and daily activity scores.
• AM-PAC scores did not significantly differ between IRF and SNF discharges and could not discriminate between these postacute care settings.

Conclusions:

• The AM-PAC Inpatient "6-Clicks" tool effectively distinguishes stroke survivors discharged to home from those requiring postacute care.
• The AM-PAC tool is not sufficient for differentiating between placement in an IRF versus an SNF for stroke survivors.
• Further research may be needed to identify specific predictors for IRF versus SNF placement in the stroke population.