• Jibby E Kurichi, Dawei Xie, Barbara E Bates, Diane Cowper Ripley, W Bruce Vogel, Pui Kwong, and Margaret G Stineman.
• Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA. Electronic address: jkurichi@mail.med.upenn.edu.
• Arch Phys Med Rehabil. 2014 Jul 1; 95 (7): 1277-1282.e3.

ObjectiveTo determine which patient-, treatment-, and facility-level characteristics were associated with home discharge among patients hospitalized for stroke within the Department of Veterans Affairs.DesignRetrospective observational study.SettingVeterans Affairs facilities nationwide.ParticipantsVeterans hospitalized for stroke during fiscal year 2007 to fiscal year 2008 (N=12,565).InterventionNot applicable.Main Outcome MeasureDischarge location after hospitalization.ResultsThere were 10,130 (80.6%) veterans discharged home after hospitalization for acute stroke. Married veterans were more likely than nonmarried veterans to be discharged home (odds ratio [OR]=1.23; 95% confidence interval [CI]=1.11-1.35). Compared with veterans admitted to the hospital from home, patients admitted from extended care were less likely to be discharged home (OR=.04; 95% CI=.03-.07). Compared with those with occlusion of cerebral arteries, patients with intracerebral hemorrhage (OR=.61; 95% CI=.50-.74) or other central nervous system hemorrhage (OR=.78; 95% CI=.63-.96) were less likely to be discharged home, whereas patients with occlusion of precerebral arteries (OR=1.36; 95% CI=1.07-1.73) were more likely to return home. Evidence of congestive heart failure (OR=.85; 95% CI=.76-.95), fluid and electrolyte disorders (OR=.86; 95% CI=.77-.96), internal organ procedures and diagnostics (OR=.87; 95% CI=.78-.97), and serious nutritional compromise (OR=.49; 95% CI=.40-.62) during hospitalization remained independently associated with lower odds of home discharge. Longer hospitalizations and receipt of rehabilitation services while hospitalized acutely were negatively associated, whereas treatment on more bed sections and rehabilitation accreditation of the facility were positively associated with home discharge. Region exerted a statistically significant effect on home discharge.ConclusionsWe found sociological, clinical, and facility-level factors associated with home discharge after hospitalization for acute stroke. Findings document the importance of considering a broad range of characteristics rather than focusing only on a few specific traits during discharge planning.Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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