Aims: Investigate factors contributing to early representation to hospital after discharge following stroke among elderly permanent aged care residents.
Methods: This retrospective study included all hospitalized patients with acute stroke aged ≥ 65 that were discharged to an aged care facility from a tertiary Victorian metropolitan hospital over three years. These patients were then followed up from discharge for 30 days. The primary outcome was any medical encounter with the various hospital-based services, the need for hospital readmission and mortality. Univariate logistic regression analysis was performed to identify factors associated with representations.
Results: 108 patients were discharged to an aged care facility after stroke. 35.5% of patients required a representation to various hospital-based services, whereas 15.7% required hospital readmission in the 30-day follow-up period. The mortality rate was 8.3% among the study population.
Factors associated with increased representations included older age (OR 1.075, CI 1.02-1.132, p < 0.01), increased comorbidities (OR 1.250, CI 1.048 -1.491 p< 0.05), lower Glasgow Coma Scale on admission (OR 0.507, CI 0.334- 0.771, p= 0.001), lower functional status on discharge (OR 2.738, CI 1.409- 5.322, p<0.01), diagnosis of delirium (OR 4.351, CI 1.603-11.806, p <0.01) and need for palliative care consultation during the index admission (OR 8.933, CI 1.810 - 44.101, p=0.007). Patients requiring representations also had a shorter subacute length of stay (OR 0.980, CI 0.962-0.997, p<0.05).
Conclusion: This is the first study investigating hospital representation among aged care residents after stroke. Further studies are recommended to analyze the pattern of healthcare utilization.