Multidiscipline Stroke Post-Acute Care Transfer System: Propensity-Score-Based Comparison of Functional Status
AbstractFew studies have investigated the characteristics of stroke inpatients after post-acute care (PAC) rehabilitation, and few studies have applied propensity score matching (PSM) in a natural experimental design to examine the longitudinal impacts of a medical referral system on functional status. This study coupled a natural experimental design with PSM to assess the impact of a medical referral system in stroke patients and to examine the longitudinal effects of the system on functional status. The intervention was a hospital-based, function oriented, 12-week to 1-year rehabilitative PAC intervention for patients with cerebrovascular diseases. The average duration of PAC in the intra-hospital transfer group (31.52 days) was significantly shorter than that in the inter-hospital transfer group (37.1 days) (p < 0.001). The intra-hospital transfer group also had better functional outcomes. The training effect was larger in patients with moderate disability (Modified Rankin Scale, MRS = 3) and moderately severe disability (MRS = 4) compared to patients with slight disability (MRS = 2). Intensive post-stroke rehabilitative care delivered by per-diem payment is effective in terms of improving functional status. To construct a vertically integrated medical system, strengthening the qualified local hospitals with PAC wards, accelerating the inter-hospital transfer, and offering sufficient intensive rehabilitative PAC days are the most essential requirements. View Full-Text
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Wang, C.-Y.; Hsien, H.-H.; Hung, K.-W.; Lin, H.-F.; Chiou, H.-Y.; Yeh, S.-C.J.; Yeh, Y.-J.; Shi, H.-Y. Multidiscipline Stroke Post-Acute Care Transfer System: Propensity-Score-Based Comparison of Functional Status. J. Clin. Med. 2019, 8, 1233.
Wang C-Y, Hsien H-H, Hung K-W, Lin H-F, Chiou H-Y, Yeh S-CJ, Yeh Y-J, Shi H-Y. Multidiscipline Stroke Post-Acute Care Transfer System: Propensity-Score-Based Comparison of Functional Status. Journal of Clinical Medicine. 2019; 8(8):1233.Chicago/Turabian Style
Wang, Chung-Yuan; Hsien, Hong-Hsi; Hung, Kuo-Wei; Lin, Hsiu-Fen; Chiou, Hung-Yi; Yeh, Shu-Chuan J.; Yeh, Yu-Jo; Shi, Hon-Yi. 2019. "Multidiscipline Stroke Post-Acute Care Transfer System: Propensity-Score-Based Comparison of Functional Status." J. Clin. Med. 8, no. 8: 1233.
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