What activities of daily living at discharge affect the discharge destination of patients in an acute‐care hospital in Japan: A retrospective factor analysis

Abstract

It is important to clarify the influence of activities of daily living (ADL) at discharge on the discharge destination of hospitalised patients. The Functional Independence Measure (FIM) is a widely used ADL assessment scale. In this retrospective study, we aimed to identify what ADL based on FIM at discharge affect the discharge destination of hospitalised patients in an acute‐care hospital, in addition to how nutritional status and the number of drugs used, as well as types of disease, affect discharge‐to‐home. We surveyed age, sex, disease type, length of hospital stay, discharge destination, FIM score at discharge, serum albumin level, and the number of continued drugs in hospitalised patients who underwent rehabilitation in Gifu Municipal Hospital (Gifu, Japan) between January 2014 and December 2014. Multiple logistic regression analysis was performed with discharge to home as a dependent variable and age, sex, disease, FIM score and polypharmacy as independent variables. Multiple logistic regression analysis indicated that a significantly high percentage of discharged‐to‐home patients were associated with ‘self‐care’ (≥33 points; OR: 2.03), ‘sphincter control’ (≥14 points; OR: 1.49), ‘transfers’ (≥13 points; OR: 1.94), and ‘locomotion’ (≥7 points; OR: 3.55), among others. High FIM sub‐scale scores at discharge for self‐care, sphincter control, transfers, and locomotion were clarified as factors associated with discharge‐to‐home. These findings of the association of ADL based on FIM and discharge destination would be useful in deciding discharge destinations for patients in an acute‐phase hospital.

Associations of postoperative delirium with activities of daily living in older people after major surgery: A prospective cohort study

“…Patients' ability to manage ADL has a direct impact on their hospital length of stay, and discharge destination. According to Tachi et al (2021), patients with a decline in ADL were associated with increased hospital length of stay and discharged to nursing home facilities compared to those with independent level of ADL (Tachi et al, 2021). Further, the ability to manage ADL independently is an important indicator of quality of life (Shevil & Finlayson, 2006), and is widely used as an index for the measurement of surgical patients postoperative recovery (Chen et al, 1995; Jonker et al, 2020).…”