Academic Editor: Boyoung Joung
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
