Iddagoda Mayura Thilanka, Inderjeeth Charles Anoopkumar, Chan Kien, Raymond Warren David
Department of Rehabilitation & Aged Care, Sir Charles Gairdner and Osborne Park Health Care Group, Perth, WA, Australia.
Department of Geriatric Medicine, Royal Perth Hospital, Perth, WA, Australia.
Australas J Ageing. 2020 Jun;39(2):e194-e200. doi: 10.1111/ajag.12742. Epub 2019 Nov 19.
Transitional care program in Australia targets older patients in hospitals requiring ongoing slow-stream restorative care prior to discharge. Poststroke patients often require extended care and are transferred to these facilities. Transitional care providers require a predicted discharge destination. The aim of this study was to assess the accuracy of this prediction.
This study included all patients transferred to transitional care from a stroke rehabilitation unit over eight years. Information regarding the predicted final discharge destination was collected from medical records, and the actual discharge destination was obtained from the transitional care registry.
Final destination prediction was equivalent between medical and multidisciplinary teams (κ = 0.87). However, only 60% of the predictions were accurate. Subgroup analysis, as measured by the Modified Barthel Index, suggested that functional gain was a better predictor of final destination. Other characteristics, such as age, sex and type of stroke, did not demonstrate good correlation with the final destination.
Functional improvement, that is the Modified Barthel Index, is the best predictor of final destination after transitional care.
澳大利亚的过渡性护理项目针对的是那些在出院前需要持续缓慢恢复性护理的老年住院患者。中风后患者通常需要长期护理，并被转至这些机构。过渡性护理提供者需要一个预测的出院目的地。本研究的目的是评估这种预测的准确性。
本研究纳入了八年间从中风康复单元转至过渡性护理的所有患者。从病历中收集有关预测的最终出院目的地的信息，并从过渡性护理登记处获取实际出院目的地。
医疗团队和多学科团队之间的最终目的地预测相当（κ = 0.87）。然而，只有60%的预测是准确的。以改良巴氏指数衡量的亚组分析表明，功能改善是最终目的地的更好预测指标。其他特征，如年龄、性别和中风类型，与最终目的地没有良好的相关性。
功能改善，即改良巴氏指数，是过渡性护理后最终目的地的最佳预测指标。
