Post-Stroke Inpatient Rehab Is Underused

Utilization of inpatient rehabilitation (IR) is low among stroke survivors in the United States, especially older women, a new study found.

Findings from the study were presented at the International Stroke Conference, which is taking place from January 24 to 26, 2018, in Los Angeles, California.
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For their study, the researchers assessed 3,112,120 patients in the 2006-2011 National Inpatient Sample with diagnoses of ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage.

Survey design multivariable logistic regression models were used to analyze national trends in IR utilization. Factors associated with IR utilization such as level of care (defined by hospital teaching status) were also evaluated.

Findings showed that only 16.2% of patients utilized IR services following a stroke (odds ratio [OR] 1.06), with 19.5% of patients discharged to IR facilities in 2011. In particular, older women had the lowest odds of utilizing IR services.

The researchers noted that, after controlling for various factors, patients who utilized IR services were significantly more likely to be discharged from a teaching hospital (OR 1.40).

“Our analysis indicates overall low nationwide IR utilization,” the researchers concluded. “However, there is an increasing trend in utilization of IR, albeit with age, gender, and [level of care] disparities. After adjustments, patients discharged from non-teaching hospitals are 29% less likely to receive IR. Further studies should focus on barriers to utilizing post-stroke IR, including socioeconomic status.”

—Christina Vogt
Reference:

Vahidy FS, Ifejika NL, Savitz SI. Nationwide trends and disparities in utilization of inpatient rehabilitation for stroke patients. Paper presented at: International Stroke Conference; January 24-26, 2018; Los Angeles, CA. http://stroke.ahajournals.org/content/49/Suppl_1/A24.