Comparisons of readmissions and mortality based on post-discharge ambulatory follow-up services received by stroke patients discharged home: a register-based study

Few studies have focused on post-discharge ambulatory care for stroke patients and subsequent differences in readmission and mortality rates. Identifying groups at higher risk according to services received is important when planning post-discharge follow-up in ambulatory care. According to a recent...

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Bibliographic Details
Published in:BMC health services research 2019-01, Vol.19 (1), p.4-4, Article 4
Main Authors: Swanson, Jayson O, Moger, Tron Anders
Format: Article
Language:English
Subjects:
Activities of daily living
Ambulatory care
Cardiovascular disease
Care and treatment
Comorbidity
Comparative analysis
Demographics
Discharge planning
Follow-up studies
General practitioners
Health services
Hemorrhage
Home care
Home nursing
Hospital admission and discharge
Hospitalization
Hospitals
Long term health care
Medical research
Mortality
Neurorehabilitation
Norway
Nursing care
Nursing services
Patient outcomes
Patient readmission
Patient safety
Patients
Primary care
Public health
Rehabilitation
Reimbursement
Stroke
Stroke patients
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Summary:Few studies have focused on post-discharge ambulatory care for stroke patients and subsequent differences in readmission and mortality rates. Identifying groups at higher risk according to services received is important when planning post-discharge follow-up in ambulatory care. According to a recent Whitepaper by the Norwegian Government, patients receiving ambulatory care should have follow-up with a general practitioner (GP) within 14 days of hospital discharge. All home discharged stroke cases occurring in Oslo from 2009 to 2014 were included. 90- and 365-day all-cause readmissions and mortality were compared separately for patients categorized based on services received (no services, home nursing, ambulatory rehabilitation and home nursing with ambulatory rehabilitation) and early GP follow-up within 14 days following discharge. Variables used to adjust for differences in health status and demographics at admission included inpatient days and comorbidities the year prior to admission, calendar year, sex, age, income, education and functional score. Cox regression reporting hazard ratios (HR) was used. There were no significant differences in readmission rates for early GP follow-up. Patients receiving home nursing and/or rehabilitation had higher unadjusted 90- and 365-day readmission rates than those without services (HR from 1.87 to 2.63 depending on analysis, p 
ISSN:1472-6963
1472-6963
DOI:10.1186/s12913-018-3809-z