ArticleJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2026
Factors associated with discharge to skilled nursing despite a clinical recommendation for inpatient rehabilitation.
Article in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
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8 authors.
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Abstract
background and purposeTwo-thirds of adults with stroke receive post-acute rehabilitation to enhance recovery. For many, higher-intensity, but more costly, rehabilitation at an inpatient rehabilitation facility (IRF) is associated with improved outcomes compared to a skilled nursing facility (SNF). Little is known on how often patients recommended for IRF discharge actually discharge to SNF. Ensuring patients receive post-acute care that aligns with clinical need is crucial for long-term outcomes. This study examined how often patients recommended for an IRF discharge after stroke hospitalization discharge to a SNF, and examined the factors associated with this discrepant discharge.
methodsRetrospective cohort study of adults hospitalized for stroke in a multi-hospital health system between January 1, 2018 - December 31, 2024. Electronic health record data identified physical and occupational therapy recommendations for an IRF discharge and the post-discharge location (IRF or SNF). A generalized logistic regression examined factors associated with SNF discharge.
resultsAmong 3388 stroke hospitalizations which recommended IRF, 3092 (91%) discharged to IRF and 296 (9%) discharged to SNF. Enrollment in Medicare Advantage (OR=2.80, 95%CI [1.68, 4.68]), traditional Medicare (OR=2.05, 95%CI [1.22, 3.43]), age ≥ 85 years (OR=1.98, 95%CI [1.17, 3.37]), dependent pre-admission mobility (OR=1.81, 95%CI [1.21, 2.70]), and acute hospital length of stay (OR=1.03, 95%CI=[1.02, 1.04] were most strongly associated with a discrepant discharge.
conclusionsAmong those recommended for IRF discharge, a SNF discharge was driven by a combination of both clinical and non-clinical factors. These results underscore the need to consider how both clinical and non-clinical factors influence this process and may impact long-term outcomes.
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