Letter by Ellis and Sheets Regarding Article, “No Racial Difference in Rehabilitation Therapy Across All Post-Acute Care Settings in the Year Following a Stroke”
1
Citation
5
Reference
10
Related Paper
Citation Trend
Keywords:
Stroke
Acute stroke
Acute care
Racial differences
Acute care
Prospective payment system
Acute hospital
Benchmarking
Inpatient care
Cite
Citations (0)
Acute care
Cite
Citations (4)
AbstractPatients hospitalized for an acute illness or injury are at risk of experiencing a significant loss of functioning as defined by the International Classification of Functioning, Disability and Health (ICF). The risk of a significant loss of functioning is increased in critically ill patients, in patients with complications or long-term intensive care stays, in persons with disabilities or with pre-existing chronic conditions and in the elderly. Early identification of rehabilitation needs and early start of rehabilitation can reduce healthcare costs by reducing dependence and nursing care, length of stay and prevention of disability. Two principles of rehabilitation for acute and early post-acute care can be distinguished. First, the provision of rehabilitation by health professionals who are generally not specialized in rehabilitation in the acute hospital. And second, specialized rehabilitation care provided by an interdisciplinary team. There is large variation how this specialized, typically post-acute rehabilitation care is organized, provided, and reimbursed in different countries, regions, and settings. For instance, it may be provided either in the acute hospital or in a rehabilitation or nursing setting. Most in-patients do not receive specialized rehabilitation at all during their whole stay in the acute hospital. But, it is important to point out that health professionals working in acute hospitals and who are not specialized in rehabilitation need to be able to recognize patients' needs for rehabilitation care and to perform rehabilitation interventions themselves or to assign patients to appropriate rehabilitation care settings. The principles outlined in this paper can serve as a basis for the development of clinical assessment instruments to describe and classify functioning, health and disability of patients receiving acute or early post-acute rehabilitation care.KeywordsRehabilitationhospitalscritical illnesschronic diseasecomplicationsfrail elderlyICFacute rehabilitationpost-acute rehabilitationloss of functioningearly rehabilitation
Acute care
Cite
Citations (151)
ABSTRACT Hospitals may transfer seniors with a hip fracture to various rehabilitation settings. Knowing the relationship between hospital teaching status and post-acute rehabilitation setting may help evaluations of the transfer from acute care. The purpose of this study was to determine the relationship between hospital teaching status and rehabilitation destination following acute care in seniors with a hip fracture. Hospital separations were linked with home care records to identify hip fractures and hospital-based or home care rehabilitation ( n = 806). Two logistic regression models determined the likelihood of transfer to any rehabilitation destination and to hospital-based versus home care rehabilitation. Teaching hospitals were no more likely than non-teaching hospitals to discharge patients to any rehabilitation (OR 1.20, 95% CI 0.88,1.65). However, among those referred to rehabilitation, the odds of discharge to hospital-based versus home care rehabilitation were almost four times greater for patients in teaching hospitals (OR 3.76, 95% CI 2.23, 6.37). The results are consistent with the availability of post-acute rehabilitation in the planning area. Future study of post-acute rehabilitation outcomes should consider hospital teaching status as an indicator of how hospital-based factors may affect the utilization of post-acute rehabilitation.
Acute care
Hip Fracture
Acute hospital
Odds
Rehabilitation hospital
Affect
Cite
Citations (2)
Burn center
Acute care
Odds
Cite
Citations (2)
Objective : To evaluate the outcome of the sub-acute rehabilitation program in stroke patients. Method : Using a retrospective analytic design to evaluate the outcomes of Suratthani hospital’s Stroke Units patients before and after the introduction of the Sub-acute rehabilitation program. Result : There was no statistical difference in the demographic characteristics between the two groups of patients except for discharge type. The number of patients receiving the rehabilitation service during admission was roughly the same, i.e. 53.8% and 56.6% respectively but statistically differed when comparing rehabilitation post-discharge, i.e. 12.2% vs 46.4% (p-value <0.001). The Barthel index (BI) was recorded after the development of Sub-acute rehabilitation program and showed 48.3% of patient was severely dependent in activity of daily living (ADLs) to moderately dependent in ADLs (BI 0-70 score). The BI wassignificant increase during follow up (Mean, SD = 56.59, 34.77) when compared with BI before discharge (Mean, SD =44.49, 27.78), (Mean diff = 12.1, p-value= 0.026). Conclusion : The introduction of the Sub-acute rehabilitation program significantly increased the number of people receiving post-discharge rehabilitation service. Keyword : Sub-acute, rehabilitation, stroke.
Acute stroke
Barthel index
Stroke
Acute hospital
Acute care
Cite
Citations (0)
The Acute Care Team Educational Initiative (ACTEI) was developed as a quality improvement initiative for the recognition and initial management of time-sensitive medical conditions. For our first time-sensitive disease process, we focused on acute stroke [acute stroke initiative (ASI)]. As part of the larger ACTEI, the ASI included creating an ACT that responds to all suspected emergency department stroke patients. In this article, we describe the planning, process, and development of the ACTEI/ASI as well as how we created an acute response team for the diagnosis and management of suspected acute stroke.
Acute stroke
Stroke
Acute care
Rapid response team
Disease management
Cite
Citations (0)
Prospective payment system
Acute care
Acute hospital
Cite
Citations (13)
Acute care
Geriatric rehabilitation
Acute hospital
Cite
Citations (1)