Over- and under-supply of inpatient rehabilitation after stroke without a post-acute rehabilitation system: a nationwide retrospective cohort study
IntroductionThis study aimed to investigate the utilization of post-ischemic stroke rehabilitation prior to the introduction of the post-acute rehabilitation system in South Korea in 2017.MethodsMedical resources utilized for patients with cerebral infarction hospitalized at Regional Cardio-Cerebrov...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1135568/full |
| _version_ | 1797802957372129280 |
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| author | Suk Won Bae Junhyun Kwon Junhyun Kwon Hyung-Ik Shin Hyung-Ik Shin |
| author_facet | Suk Won Bae Junhyun Kwon Junhyun Kwon Hyung-Ik Shin Hyung-Ik Shin |
| author_sort | Suk Won Bae |
| collection | DOAJ |
| description | IntroductionThis study aimed to investigate the utilization of post-ischemic stroke rehabilitation prior to the introduction of the post-acute rehabilitation system in South Korea in 2017.MethodsMedical resources utilized for patients with cerebral infarction hospitalized at Regional Cardio-Cerebrovascular Centers (RCCVCs) of 11 tertiary hospitals were tracked until 2019. Stroke severity was classified according to the National Institutes of Health Stroke Scale (NIHSS), and multivariate regression analysis was performed to analyze factors influencing the length of hospital stay (LOS).ResultsThis study included 3,520 patients. Among 939 patients with stroke with moderate or greater severity, 209 (22.3%) returned home after RCCVC discharge without inpatient rehabilitation. Furthermore, 1,455 (56.4%) out of 2,581 patients with minor strokes with NIHSS scores ≤4 were readmitted to another hospital for rehabilitation. The median LOS of patients who received inpatient rehabilitation after RCCVC discharge was 47 days. During the inpatient rehabilitation period, the patients were admitted to 2.7 hospitals on average. The LOS was longer in the lowest-income group, high-severity group, and women.ConclusionBefore the introduction of the post-acute rehabilitation system, treatment after stroke was both over- and under-supplied, thus delaying home discharge. These results support the development of a post-acute rehabilitation system that defines the patients, duration, and intensity of rehabilitation. |
| first_indexed | 2024-03-13T05:13:35Z |
| format | Article |
| id | doaj.art-ecdd2217baa5469e8836ba4808b7581f |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-13T05:13:35Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-ecdd2217baa5469e8836ba4808b7581f2023-06-16T05:07:10ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-06-011410.3389/fneur.2023.11355681135568Over- and under-supply of inpatient rehabilitation after stroke without a post-acute rehabilitation system: a nationwide retrospective cohort studySuk Won Bae0Junhyun Kwon1Junhyun Kwon2Hyung-Ik Shin3Hyung-Ik Shin4Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of KoreaDepartment of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of KoreaInstitute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of KoreaDepartment of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of KoreaDepartment of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Republic of KoreaIntroductionThis study aimed to investigate the utilization of post-ischemic stroke rehabilitation prior to the introduction of the post-acute rehabilitation system in South Korea in 2017.MethodsMedical resources utilized for patients with cerebral infarction hospitalized at Regional Cardio-Cerebrovascular Centers (RCCVCs) of 11 tertiary hospitals were tracked until 2019. Stroke severity was classified according to the National Institutes of Health Stroke Scale (NIHSS), and multivariate regression analysis was performed to analyze factors influencing the length of hospital stay (LOS).ResultsThis study included 3,520 patients. Among 939 patients with stroke with moderate or greater severity, 209 (22.3%) returned home after RCCVC discharge without inpatient rehabilitation. Furthermore, 1,455 (56.4%) out of 2,581 patients with minor strokes with NIHSS scores ≤4 were readmitted to another hospital for rehabilitation. The median LOS of patients who received inpatient rehabilitation after RCCVC discharge was 47 days. During the inpatient rehabilitation period, the patients were admitted to 2.7 hospitals on average. The LOS was longer in the lowest-income group, high-severity group, and women.ConclusionBefore the introduction of the post-acute rehabilitation system, treatment after stroke was both over- and under-supplied, thus delaying home discharge. These results support the development of a post-acute rehabilitation system that defines the patients, duration, and intensity of rehabilitation.https://www.frontiersin.org/articles/10.3389/fneur.2023.1135568/fullstrokerehabilitationpost-acute phaselength of hospital stayhospitalization |
| spellingShingle | Suk Won Bae Junhyun Kwon Junhyun Kwon Hyung-Ik Shin Hyung-Ik Shin Over- and under-supply of inpatient rehabilitation after stroke without a post-acute rehabilitation system: a nationwide retrospective cohort study Frontiers in Neurology stroke rehabilitation post-acute phase length of hospital stay hospitalization |
| title | Over- and under-supply of inpatient rehabilitation after stroke without a post-acute rehabilitation system: a nationwide retrospective cohort study |
| title_full | Over- and under-supply of inpatient rehabilitation after stroke without a post-acute rehabilitation system: a nationwide retrospective cohort study |
| title_fullStr | Over- and under-supply of inpatient rehabilitation after stroke without a post-acute rehabilitation system: a nationwide retrospective cohort study |
| title_full_unstemmed | Over- and under-supply of inpatient rehabilitation after stroke without a post-acute rehabilitation system: a nationwide retrospective cohort study |
| title_short | Over- and under-supply of inpatient rehabilitation after stroke without a post-acute rehabilitation system: a nationwide retrospective cohort study |
| title_sort | over and under supply of inpatient rehabilitation after stroke without a post acute rehabilitation system a nationwide retrospective cohort study |
| topic | stroke rehabilitation post-acute phase length of hospital stay hospitalization |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1135568/full |
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