Researchers at the Brown University School of Public Health have found that receiving hospital based rehabilitative care after a stroke is associated with lower readmission to hospitals within a thirty day time period. The study was lead by Dr. Amit Kumar, assistant professor at Northern Arizona University, Flagstaff, Arizona, who completed his postdoctoral research at the Brown University School of Public Health, was accepted for publication in the Archives of Physical Medicine and Rehabilitation.
The authors used various forms of Medicare data to do their analysis. As such those included in the study were over 66, had been diagnosed with ischemic stroke and had been admitted to and discharged from a hospital between January 1 and November 30, 2010. Fourteen percent of stroke patients were rehospitalized within 30 days and they were more likely to be older, Black and enrolled in both Medicare and Medicaid programs. After looking at the types of care patients received post stroke and rates of readmission, they found that receiving physical therapy at the hospital after a stroke, reduced the chances of being readmitted within 30 days.
Prior studies have found similar results, however, this is the first study to measure treatment in the form of time (i.e: how many minutes of physical therapy the patient received), whereas previous studies relied on measures of charges and payments. The authors point out that the United States health care system is moving from volume-based to value-based care, and as this happens, there will be a need for more clinical trials that aim to improve the management of care of patients after stroke. This study, the authors suggest, provides more evidence for the benefits of hospital-based rehabilitation services, in particular for reducing the risk of readmission for patients with ischemic stroke.
This research was supported by the NIH and Foundation for Physical Therapy’s Center on Excellence in Health Services and Health Policy Research and Training Grant.