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Purpose: Early aggressive rehabilitation therapies maximize functional recovery. We examined patient-reported preferences for their initial rehabilitation therapy setting during their acute stroke hospitalization and whether there was an association between their preferences and their actual discharge destination. Method: Eligible stroke patients were surveyed during their acute hospital stay at either a primary stroke center or a rural community hospital in North Carolina. Patients were questioned about their knowledge of inpatient rehabilitation, preferences for the initial rehabilitation therapy setting and intensity, and how far from home they were willing to travel to receive therapies. The primary outcome was their actual discharge destination. The exposure variable was their preference for initial rehabilitation therapy setting. Logistic regression models assessed the relationship between the outcome and exposure while controlling for other variables of interest. Results: Among 53 patients surveyed in the study, 85% preferred to be discharged home. After controlling for other factors, discharge to the actual destination of home was associated with a preference for an initial rehabilitation therapy setting of home (OR, 7.19; 95% CI, 1.10-46.89). Conclusion: Patient preference for the initial rehabilitation therapy setting is home. Providers should inquire about patient preference and provide information about treatment options to help inform decision making. [ABSTRACT FROM AUTHOR]

The article assesses the factors associated with discharge disposition to either inpatient rehabilitation or home after acute stroke hospitalization. The authors found that older age, a greater number of intensive care unit days, higher total therapy charges and lower poverty in their country of residence were associated with discharge to acute inpatient rehabilitation. The authors also report that factors associated with discharge to home included younger age, fewer intensive care unit days, lower therapy charges and higher poverty in their country of residence.

The article evaluates the association of race and acute discharge to inpatient stroke rehabilitation in the state of Maryland. The study used the data from the Maryland Health Services Cost Review Commission database for 2000 in determining the rate of disposition to inpatient rehabilitation facilities. Multiple logistic regression analyses were used to examine factors related with discharge to inpatient rehabilitation facilities in black patients. It was found that urban-dwelling black stroke patients were more likely to be discharged to inpatient rehabilitation facilities acutely after stroke.

The article presents a study that evaluates the connection between race and medical referral to cardiac rehabilitation programs in Baltimore, Maryland. It was revealed that racial disparities exist in recommendation for cardiac rehabilitation programs in city hospitals. White Americans tend to be referred for cardiac treatment than African Americans. Race is noted to be one of the factors that affects the accessibility of adequate health services. Researchers suggest the provision of educational programs to patients and healthcare providers about the services for cardiac rehabilitation initiatives.