• Jibby E Kurichi, Diane Cowper Ripley, Dawei Xie, Pui L Kwong, Barbara E Bates, and Margaret G Stineman.
• Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA.
• PM R. 2013 May 1; 5 (5): 408-17.

ObjectiveTo determine the patient-, treatment-, and facility-level factors that are associated with home discharge among male veterans with lower extremity amputation who received inpatient rehabilitation after surgery.DesignA retrospective observational study.SettingVeterans Affairs Medical Centers.ParticipantsThis study included 1480 male veterans.MethodsGeneralized estimating equation models were used to model the likelihood of home discharge to account for within-facility clustering. We reported odds ratios (ORs) and 95% confidence intervals (95% CIs).Main Outcome MeasurementDischarged to home.ResultsThere were a total of 1163 (78.6%) veterans who were discharged home after the surgical hospitalization, compared with other locations. Patients who were married were more likely to be discharged home compared with patients who were not married (OR = 1.51, 95% CI = 1.14-1.99, P < .01). Compared with being transferred from another hospital or extended care, patients who were admitted from home were far more likely to be discharged home (OR = 8.43, 95% CI = 5.48-12.96, P < .0001). Patients with evidence of local significant infection were less likely to be discharged home (OR = 0.57, 95% CI = 0.39-0.83, P < .01), as were patients with evidence of congestive heart failure (OR = 0.62, 95% CI = 0.45-0.85, P < .01) or depression (OR = 0.63, 95% CI = 0.40-0.98, P = .04). Veterans with greater discharge motor Functional Independence Measure scores were more likely to be discharged home (OR = 1.23, 95% CI = 1.16-1.31 per 10-point increase in discharge Functional Independence Measure motor score, P < .0001). Conversely, patients undergoing procedures for ongoing active cardiac pathology were less likely to be discharged home (OR = 0.55, 95% CI = 0.37-0.81, P < .01).ConclusionsThis study showed a strong association between the sociological factors of marital status and living location before hospitalization and home discharge. The significance of discharge functional status highlights the importance of addressing the expected care burden once patients are discharged home.Copyright © 2013 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

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