• Tetsuo Koyama, Yukari Sako, Misa Konta, and Kazuhisa Domen.
• Department of Rehabilitation Medicine, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Hyogo, Japan. ytkoyama@bd6.so-net.ne.jp
• J Stroke Cerebrovasc Dis. 2011 May 1;20(3):202-7.

AbstractTo assess how functional independence and sociodemographic factors influence discharge destination of patients recovering from stroke in urban Japan. Patients recovering from first-ever stroke (supratentorial lesions) discharged from a long-term rehabilitation hospital. Scores for individual patients were collected at both admission and discharge for the motor components of the Functional Independence Measure (FIM-m), and FIM-m increase was ascertained; patients were also surveyed to gather data for explanatory variables: age, sex, type of stroke, length of hospital stay, number of people in the household, co-residence with a spouse, and number of sons/daughters. Outcomes were defined as dichotomous categories, discharge to home versus to a nursing home. Logistic analyses were performed on these data. Of the 163 patients enrolled in the study, 123 were discharged to home and 40 were discharged to a nursing home. Analyses showed that older age and lower FIM-m scores at both admission and discharge were associated with greater probability of discharge to a nursing home. The number of children, including sons/daughters living in separate households, had no statistically significant relationship to discharge destination. Patients without a spouse at home who lived in less populous households were more likely to be discharged to a nursing home. Meanwhile, improvement in FIM-m score was not statistically significantly related to discharge destination. Our findings indicate that level of functional independence and number of co-resident household members are powerful predictors of discharge destination. For patients with a lower level of functional independence, the presence of a social network to provide support and care is a decisive factor in discharge to home.Copyright © 2011 National Stroke Association. Published by Elsevier Inc. All rights reserved.

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