IMR Press / RCM / Volume 23 / Issue 10 / DOI: 10.31083/j.rcm2310328
Open Access Original Research
Factors Associated with Receiving a Discharge Care Plan After Stroke in Australia: A Linked Registry Study
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1 Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC 3168, Australia
2 Stroke Theme, The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, VIC 3084, Australia
3 Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC 3800, Australia
4 Alfred Health, Melbourne, VIC 3800, Australia
5 Department of Medicine, Peninsula Clinical School, Monash University, and National Centre for Healthy Ageing, Frankston, VIC 3199, Australia
6 Department of Medicine, St Vincent’s Hospital, University of Melbourne, Fitzroy, VIC 3065, Australia
*Correspondence: muideen.olaiya@monash.edu (Muideen T Olaiya)
Academic Editor: Boyoung Joung
Rev. Cardiovasc. Med. 2022, 23(10), 328; https://doi.org/10.31083/j.rcm2310328
Submitted: 28 June 2022 | Revised: 27 August 2022 | Accepted: 5 September 2022 | Published: 28 September 2022
(This article belongs to the Special Issue Cardiovascular Health and Cerebrovascular Disorders)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Discharge planning is recommended to optimise the transition from acute care to home for patients admitted with stroke. Despite this guideline recommendation, many patients do not receive a discharge care plan. Also, there is limited evidence on factors influencing the provision of discharge care plan post-stroke. We evaluated patient, clinical and system factors associated with receiving a care plan on discharge from hospital back to the community after stroke. Methods: This was an observational cohort study of patients with acute stroke who were discharged to the community between 2009–2013, using data from the Australian Stroke Clinical Registry linked to hospital administrative data. For this analysis, we used merged dataset containing information on patient demographics, clinical characteristics, and receipt of acute care processes. Multivariable logistic regression models were used to determine factors associated with receiving a discharge care plan. Results: Among 7812 eligible patients (39 hospitals, median age 73 years, 44.7% female, 56.9% ischaemic stroke), 47% received a care plan at discharge. The odds of receiving a discharge care plan increased over time (odds ratio [OR] 1.39 per year, 95% CI 1.37–1.48), and varied between hospitals. Factors associated with receiving a discharge care plan included greater socioeconomic position (OR 1.18, 95% CI 1.02–1.38), diagnosis of ischaemic stroke (OR 1.18, 95% CI 1.05–1.33), greater stroke severity (OR 1.15, 95% CI 1.01–1.31), or being discharged on antihypertensive medication (OR 3.07, 95% CI 2.69–3.50). In contrast, factors associated with a reduced odds of receiving a discharge care plan included being aged 85+ years (vs<85 years; OR 0.79, 95% CI 0.64–0.96), discharged on a weekend (OR 0.56, 95% CI 0.46–0.67), discharged to residential aged care (OR 0.48, 95% CI 0.39–0.60), or being treated in a large hospital (>300 beds; OR 0.30, 95% CI 0.10–0.92). Conclusions: Implementing practices to target people who are older, discharged to residential aged care, or discharged on a weekend may improve discharge planning and post-discharge care after stroke.

Keywords
patient discharge
quality of care
stroke
Australia
data linkage
Funding
1034415/National Health and Medical Research Council (NHMRC) Stroke123 Partnership Grant
1109426/National Health and Medical Research Council
1072053/National Health and Medical Research Council
1042600/National Health and Medical Research Council
1063761/National Health and Medical Research Council
1154273/Heart Foundation
1112158/National Health and Medical Research Council
Figures
Fig. 1.
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