Selection of Postacute Stroke Rehabilitation Facilities: A Survey of Discharge Planners From the Northeast Cerebrovascular Consortium (NECC) Region.
Abstract
The process of determining the level of care and specific postacute care facility
for stroke patients has not been adequately studied. The objective of this study was
to better understand the factors that influence postacute care decisions by surveying
stroke discharge planners. Requests were sent to discharge planners at 471 hospitals
in the Northeast United States to complete an online survey regarding the factors
impacting the selection of postacute care. Seventy-seven (16%) discharge planners
completed the online survey. Respondents were mainly nurses and social workers and
73% reported ≥20 years healthcare experience. Patients and families were found to
be significantly more influential than physicians (P < 0.001) and other clinicians
(P = 0.04) in influencing postdischarge care. Other clinicians were significantly
more influential than physicians (P < 0.001). Insurance and quality of postacute care
were the factors likely to most affect the selection of postacute care facility. Insurance
was also identified as the greatest barrier in the selection of level of postacute
care (70%; P < 0.001) and specific postacute care facility (46%; P = 0.02). More than
half reported that pressure to discharge patients quickly impacts a patients' final
destination. Nonclinical factors are perceived by discharge planners to have a major
influence on postacute stroke care decision making.
Type
Journal articleSubject
Acute DiseaseFemale
Humans
Incidence
Male
New England
New Jersey
New York
Patient Discharge
Pilot Projects
Rehabilitation Centers
Stroke
Stroke Rehabilitation
Surveys and Questionnaires
Survival Rate
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https://hdl.handle.net/10161/11982Published Version (Please cite this version)
10.1097/MD.0000000000003206Publication Info
Magdon-Ismail, Zainab; Sicklick, Alyse; Hedeman, Robin; Bettger, Janet Prvu; & Stein,
Joel (2016). Selection of Postacute Stroke Rehabilitation Facilities: A Survey of Discharge Planners
From the Northeast Cerebrovascular Consortium (NECC) Region. Medicine (Baltimore), 95(16). pp. e3206. 10.1097/MD.0000000000003206. Retrieved from https://hdl.handle.net/10161/11982.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Janet Prvu Bettger
Associate Professor in Orthopaedic Surgery
Dr. Bettger’s research is dedicated to establishing real world evidence aimed to improve
health care quality and policies that reduce the burden of disease and disability.
As a health services researcher and implementation scientist, her research extends
from observational studies to randomized and pragmatic trials. She is currently the
Director of Duke Roybal Center for Translational Research in the Behavioral and Social
Sciences of Aging and Director of Undergraduate Initiatives

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