Retrospective analysis of Get With the Guidelines-Stroke data linked with Medicare claims and the AVAIL longitudinal data sets to assess patterns, predictors, and outcomes associated with the use of rehabilitation services following hospitalization for ischemic stroke. Primary completion defined as the end of primary analyses, consistent with the end of the PCORI Cycle I grant period. Study completion defined as acceptance of final research report and lay abstract by PCORI.
The investigators will seek to answer three questions:
1. What are the person- and system-level factors associated with use of rehabilitation services following acute ischemic stroke?
2. Among stroke survivors discharged to short-term inpatient rehabilitation, are high-intensity services performed at an Inpatient Rehabilitation Facility (IRF) more effective than lower intensity services performed at a Skilled Nursing Facility (SNF), at improving patient outcomes at 3 and 12 months?
3. Among stroke survivors discharged home, is early follow-up with a physician more effective than follow-up after 7 days at 3 and 12 months?
- Retrospective analysis Other
Intervention Desc: Analysis of data for patients hospitalized in 2006-2008 with acute ischemic stroke, and successfully linked with Medicare claims through 2009
- Observation: Cohort
- Perspective: Retrospective
- Sampling: Non-Probability Sample
Patients hospitalized for acute ischemic stroke in 2006-2008, and successfully linked to Medicare claims available through 2009
|Type||Measure||Time Frame||Safety Issue|
|Primary||Rehabilitation service use||discharge through 30 days||No|
|Primary||Living independently||3 and 12 months post-discharge||No|
|Secondary||Functional status||3 and 12 months post-discharge||No|
|Secondary||Depression||3 and 12 months post-discharge||No|
|Secondary||Change in work status||3 and 12 months post-discharge||No|
|Secondary||Disease self-management||3 and 12 months post-discharge||No|
|Secondary||Quality of life||3 and 12 months post-discharge||No|
|Secondary||Long-term care placement||12 months post-discharge||No|
|Secondary||Hospital readmission||12 months post-discharge||No|
|Secondary||Survival||12 months post-discharge||No|
|Primary||Number of Participants Receiving Inpatient, Home, or Community Based Rehabilitation Services||discharge through 90 days|
|Primary||Home-time||12 months post-discharge|
|Secondary||Number of Participants Who Were Functionally Dependent or Dead 12 Months After Hospital Discharge||12 months post-discharge|
|Secondary||Quality of Life (QOL)||12 months post-discharge|
|Secondary||Number of Participants Who Were Institutionalized in a Nursing Home for Long-term Care Within 12 Months of Hospital Discharge.||12 months post-discharge|
|Secondary||Number of Participants Who Were Rehospitalized or Died Within 12 Months of Stroke Hospitalization.||12 months post-discharge|
|Secondary||Number of Participants Who Died Within 12 Months of Stroke Hospitalization||12 months post-discharge|