Physiatrist referral preferences for postacute stroke rehabilitation

Abstract

This study was intended to determine if there is variation among physiatrists in referral preferences for postacute rehabilitation for stroke patients based on physician demographic characteristics or geography.A cross-sectional survey study was developed with 5 fictional case vignettes that included information about medical, social, and functional domains. Eighty-six physiatrist residents, fellows, and attendings were asked to select the most appropriate postacute rehabilitation setting and also to rank, by importance, 15 factors influencing the referral decision. Chi-square bivariate analysis was used to analyze the data.Eighty-six surveys were collected over a 3-day period. Bivariate analysis (using chi-square) showed no statistically significant relationship between any of the demographic variables and poststroke rehabilitation preference for any of the cases. The prognosis for functional outcome and quality of postacute facility had the highest mean influence ratings (8.63 and 8.31, respectively), whereas location of postacute facility and insurance had the lowest mean influence ratings (5.74 and 5.76, respectively).Physiatrists’ referral preferences did not vary with any identified practitioner variables or geographic region; referral preferences only varied significantly by case.

Care process for stroke patients in kenya: mixed study

“…Approximately 86.6% of the patients were referred to hospital/center-based settings to continue with physiotherapy. The results of the current study echo the study conducted by Cormier [29]. The authors reported that 73% of the older American stroke survivors receive institutional rehabilitation care.…”

Selection of Post-Acute Care for Stroke Patients

“…This study builds on a prior study (Cormier et al, 2016) that used these same vignettes to conduct a survey of physiatrists' referral practices for the postacute stroke population. The surveys used in the physician study and in the current study were nearly identical, except that the collected demographic information was adjusted to reflect the target population.…”

“…The remainder of the survey asked the respondents to select the most appropriate postacute level of care for each of five acute stroke survivors, presented in the form of case vignettes with the assumption that each patient was being treated in a stroke unit after suffering an acute stroke and that the referral decision was made within a week after stroke. The five case vignettes (see Table 1) were the same as those used in a similar study examining postacute stroke care referral patterns of physiatrists (Cormier, Frantz, Rand, & Stein, 2016). The cases were written to represent relatively common scenarios encountered in acute care hospitals surrounding appropriate discharge plans for patients after acute stroke.…”

Factors influencing clinicians' referral or admission decisions for post‐acute stroke or traumatic brain injury rehabilitation: A scoping review

“…Patients' mental status 23,25,[27][28][29][30][32][33][34][35] as well as patients' energy and drive (e.g., motivation) 10,23,25,[27][28][29][30]32,34,35 are other frequently reported factors. Both affect patients' ability to engage in rehabilitation and make functional gains 23,25,32 .…”