University of British Columbia, Faculty of Medicine, Division of Physical Medicine and Rehabilitation, Vancouver, BC, Canada; GF Strong Rehabilitation Centre, Vancouver, BC, Canada.
Simon Fraser University, Faculty of Health Sciences, Burnaby, BC, Canada; Arthritis Research Center of Canada, Richmond, BC, Canada.
Arch Phys Med Rehabil. 2014 Jan;95(1):74-8. doi: 10.1016/j.apmr.2013.08.014. Epub 2013 Aug 31.
To determine rehabilitation length of stay (LOS) for patients with stroke in Canada, and to evaluate which factors contribute to variations in LOS.
A retrospective cohort study of Canadians rehabilitating from stroke using medical, functional, and sociodemographic variables extracted from the Canadian Institute for Health Information's National Rehabilitation Reporting System.
Canadian rehabilitation hospitals providing stroke rehabilitation services.
Patients with stroke (N=11,983) admitted to rehabilitation hospitals from January 2008 through December 2009.
None.
Rehabilitation LOSs were calculated nationally and regionally. Regression models incorporating sociodemographic and clinical measures were constructed to test their effect on LOS.
The median stroke rehabilitation LOSs was 35 days (quartiles: 20d, 54d). LOSs varied regionally within Canada. A multivariable regression model including age, FIM motor function scores at admission, and geographic region explained 20% of the variation in LOSs. Modeling these data using a Function-Related Groups case-mix model explained 16% of the variation in LOSs.
FIM motor function scores at admission along with age and geographic region best predicted rehabilitation LOS. These variables explained 20% of the variation in LOSs. Despite regional differences in LOSs, patient characteristics were similar between regions. Other nonpatient factors not captured in these data may contribute to a greater extent in determining stroke rehabilitation LOS.
确定加拿大脑卒中患者的康复住院时间(LOS),并评估哪些因素导致 LOS 存在差异。
一项对在加拿大接受脑卒中康复治疗的患者进行的回顾性队列研究,使用从加拿大健康信息研究所的国家康复报告系统中提取的医疗、功能和社会人口统计学变量。
提供脑卒中康复服务的加拿大康复医院。
2008 年 1 月至 2009 年 12 月期间入住康复医院的脑卒中患者(N=11983)。
无。
计算全国和地区的康复 LOS。构建包含社会人口统计学和临床测量的回归模型,以检验其对 LOS 的影响。
脑卒中康复 LOS 的中位数为 35 天(四分位距:20d,54d)。加拿大各地区的 LOS 存在差异。包括年龄、入院时的 FIM 运动功能评分和地理位置在内的多变量回归模型解释了 LOS 差异的 20%。使用功能相关分组病例组合模型对这些数据进行建模,解释了 LOS 差异的 16%。
入院时的 FIM 运动功能评分以及年龄和地理位置可较好地预测康复 LOS。这些变量解释了 LOS 差异的 20%。尽管 LOS 存在地区差异,但各地区患者的特征相似。这些数据未捕获的其他非患者因素可能在更大程度上决定了脑卒中康复 LOS。