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Abstract：
BACKGROUND: Studies examining factors associated with patient referral to early supported discharge (ESD)/outpatient rehabilitation (OPR) programs and utilization of ESD/OPR services after discharge from inpatient stroke rehabilitation (IPR) are scarce. Accordingly, we examined utilization of ESD/OPR services following discharge from IPR and patient factors associated with service utilization.
METHODS: Stroke patients discharged from IPR facilities in Alberta between April 2014 and March 2016 were included and followed for one year for ESD/OPR service utilization. Multivariable linear and negative binomial regressions were used to examine association of patients\' factors with ESD/OPR use.
RESULTS: We included 752 patients (34.4% of 2,187 patients discharged from IPR) who had 40,772 ESD/OPR visits during one year of follow-up in the analysis. Mean and median ESD/OPR visits were 54.2 and 36 visits, respectively. Unadjusted ESD/OPR visits were lower in females and patients aged ≥ 60 years but were similar between urban and rural areas. After adjustment for patient factors, patients in urban areas and discharged home after IPR were associated with 83.5% and 61.9%, respectively, increase in ESD/OPR visits, while having a right-body stroke was associated with 23.5% increase. Older patients used ESD/OPR less than their younger counterparts (1.4% decrease per one year of older age). Available factors explained 12.3% of variation in ESD/OPR use.
CONCLUSIONS: ESD/OPR utilization after IPR in Alberta was low and varied across age and geographic locations. Factors associated with use of ESD/OPR were identified but they could not fully explain variation of ESD/OPR use.
METHODS: Stroke patients discharged from IPR facilities in Alberta between April 2014 and March 2016 were included and followed for one year for ESD/OPR service utilization. Multivariable linear and negative binomial regressions were used to examine association of patients\' factors with ESD/OPR use.
RESULTS: We included 752 patients (34.4% of 2,187 patients discharged from IPR) who had 40,772 ESD/OPR visits during one year of follow-up in the analysis. Mean and median ESD/OPR visits were 54.2 and 36 visits, respectively. Unadjusted ESD/OPR visits were lower in females and patients aged ≥ 60 years but were similar between urban and rural areas. After adjustment for patient factors, patients in urban areas and discharged home after IPR were associated with 83.5% and 61.9%, respectively, increase in ESD/OPR visits, while having a right-body stroke was associated with 23.5% increase. Older patients used ESD/OPR less than their younger counterparts (1.4% decrease per one year of older age). Available factors explained 12.3% of variation in ESD/OPR use.
CONCLUSIONS: ESD/OPR utilization after IPR in Alberta was low and varied across age and geographic locations. Factors associated with use of ESD/OPR were identified but they could not fully explain variation of ESD/OPR use.
摘要：
背景：研究与患者转诊早期支持出院（ESD）/门诊康复（OPR）计划以及住院卒中康复（IPR）出院后使用ESD/OPR服务相关因素的研究很少。因此，我们检查了IPR出院后ESD/OPR服务的利用情况以及与服务利用相关的患者因素.
方法：纳入2014年4月至2016年3月从艾伯塔省IPR机构出院的卒中患者，并随访一年，以利用ESD/OPR服务。多变量线性和负二项回归用于检查患者因素与ESD/OPR使用的关联。
结果：我们纳入了752名患者（2,187名IPR出院患者中的34.4%），他们在一年的随访中接受了40,772次ESD/OPR访视。平均和中位数ESD/OPR访问分别为54.2次和36次，分别。女性和年龄≥60岁患者的未调整ESD/OPR访视率较低，但城市和农村地区相似。在调整患者因素后，城市地区和出院后的IPR患者分别为83.5%和61.9%，分别,增加ESD/OPR访问，而右体卒中与23.5%的增加相关。年龄较大的患者使用ESD/OPR的次数少于年龄较小的患者（年龄每一年减少1.4%）。可用因素解释了ESD/OPR使用差异的12.3%。
结论：艾伯塔省IPR后的ESD/OPR利用率较低，并且因年龄和地理位置而异。确定了与使用ESD/OPR相关的因素，但它们不能完全解释ESD/OPR使用的变化。
方法：纳入2014年4月至2016年3月从艾伯塔省IPR机构出院的卒中患者，并随访一年，以利用ESD/OPR服务。多变量线性和负二项回归用于检查患者因素与ESD/OPR使用的关联。
结果：我们纳入了752名患者（2,187名IPR出院患者中的34.4%），他们在一年的随访中接受了40,772次ESD/OPR访视。平均和中位数ESD/OPR访问分别为54.2次和36次，分别。女性和年龄≥60岁患者的未调整ESD/OPR访视率较低，但城市和农村地区相似。在调整患者因素后，城市地区和出院后的IPR患者分别为83.5%和61.9%，分别,增加ESD/OPR访问，而右体卒中与23.5%的增加相关。年龄较大的患者使用ESD/OPR的次数少于年龄较小的患者（年龄每一年减少1.4%）。可用因素解释了ESD/OPR使用差异的12.3%。
结论：艾伯塔省IPR后的ESD/OPR利用率较低，并且因年龄和地理位置而异。确定了与使用ESD/OPR相关的因素，但它们不能完全解释ESD/OPR使用的变化。
