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Hospital Discharge Disposition of Stroke Patients in Tennessee.

Abstract Early determination of hospital discharge disposition status at an acute admission is extremely important for stroke management and the eventual outcomes of patients with stroke. We investigated the hospital discharge disposition of patients with stroke residing in Tennessee and developed a predictive tool for clinical adoption. Our investigational aims were to evaluate the association of selected patient characteristics with hospital discharge disposition status and predict such status at the time of an acute stroke admission.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title southern medical journal
Publication Year Start




PMID- 28863224
OWN - NLM
STAT- In-Process
DA  - 20170901
LR  - 20170901
IS  - 1541-8243 (Electronic)
IS  - 0038-4348 (Linking)
VI  - 110
IP  - 9
DP  - 2017 Sep
TI  - Hospital Discharge Disposition of Stroke Patients in Tennessee.
PG  - 594-600
LID - 10.14423/SMJ.0000000000000694 [doi]
AB  - OBJECTIVES: Early determination of hospital discharge disposition status at an
      acute admission is extremely important for stroke management and the eventual
      outcomes of patients with stroke. We investigated the hospital discharge
      disposition of patients with stroke residing in Tennessee and developed a
      predictive tool for clinical adoption. Our investigational aims were to evaluate 
      the association of selected patient characteristics with hospital discharge
      disposition status and predict such status at the time of an acute stroke
      admission. METHODS: We analyzed 127,581 records of patients with stroke
      hospitalized between 2010 and 2014. Logistic regression was used to generate odds
      ratios with 95% confidence intervals to examine the factor outcome association.
      An easy-to-use clinical predictive tool was built by using integer-based risk
      scores derived from coefficients of multivariable logistic regression. RESULTS:
      Among the 127,581 records of patients with stroke, 86,114 (67.5%) indicated home 
      discharge and 41,467 (32.5%) corresponded to facility discharge. All considered
      patient characteristics had significant correlations with hospital discharge
      disposition status. Patients were at greater odds of being discharged to another 
      facility if they were women; older; black; patients with a subarachnoid or
      intracerebral hemorrhage; those with the comorbidities of diabetes mellitus,
      heart disease, hypertension, chronic kidney disease, arrhythmia, or depression;
      those transferred from another hospital; or patients with Medicare as the primary
      payer. A predictive tool had a discriminatory capability with area under the
      curve estimates of 0.737 and 0.724 for derivation and validation cohorts,
      respectively. CONCLUSIONS: Our investigation revealed that the hospital discharge
      disposition pattern of patients with stroke in Tennessee was associated with the 
      key patient characteristics of selected demographics, clinical indicators, and
      insurance status. These analyses resulted in the development of an easy-to-use
      predictive tool for early determination of hospital discharge disposition status.
FAU - Cho, Jin S
AU  - Cho JS
AD  - From the Departments of Computer Science and Engineering, Physical Therapy,
      Health and Human Performance, University of Tennessee, Chattanooga, and Erlanger 
      Health System, Chattanooga, Tennessee.
FAU - Hu, Zhen
AU  - Hu Z
AD  - From the Departments of Computer Science and Engineering, Physical Therapy,
      Health and Human Performance, University of Tennessee, Chattanooga, and Erlanger 
      Health System, Chattanooga, Tennessee.
FAU - Fell, Nancy
AU  - Fell N
AD  - From the Departments of Computer Science and Engineering, Physical Therapy,
      Health and Human Performance, University of Tennessee, Chattanooga, and Erlanger 
      Health System, Chattanooga, Tennessee.
FAU - Heath, Gregory W
AU  - Heath GW
AD  - From the Departments of Computer Science and Engineering, Physical Therapy,
      Health and Human Performance, University of Tennessee, Chattanooga, and Erlanger 
      Health System, Chattanooga, Tennessee.
FAU - Qayyum, Rehan
AU  - Qayyum R
AD  - From the Departments of Computer Science and Engineering, Physical Therapy,
      Health and Human Performance, University of Tennessee, Chattanooga, and Erlanger 
      Health System, Chattanooga, Tennessee.
FAU - Sartipi, Mina
AU  - Sartipi M
AD  - From the Departments of Computer Science and Engineering, Physical Therapy,
      Health and Human Performance, University of Tennessee, Chattanooga, and Erlanger 
      Health System, Chattanooga, Tennessee.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - South Med J
JT  - Southern medical journal
JID - 0404522
EDAT- 2017/09/02 06:00
MHDA- 2017/09/02 06:00
CRDT- 2017/09/02 06:00
AID - 10.14423/SMJ.0000000000000694 [doi]
AID - SMJ50423 [pii]
PST - ppublish
SO  - South Med J. 2017 Sep;110(9):594-600. doi: 10.14423/SMJ.0000000000000694.