What activities of daily living at discharge affect the discharge destination of patients in an acute-care hospital in Japan: A retrospective factor analysis.
Functional Independence Measure
activities of daily living
acute-care hospital
discharge destination
multiple logistic regression analysis
Journal
The International journal of health planning and management
ISSN: 1099-1751
Titre abrégé: Int J Health Plann Manage
Pays: England
ID NLM: 8605825
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
received:
17
08
2020
accepted:
12
04
2021
pubmed:
25
4
2021
medline:
30
9
2021
entrez:
24
4
2021
Statut:
ppublish
Résumé
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.
Types de publication
Journal Article
Langues
eng
Pagination
1326-1337Informations de copyright
© 2021 John Wiley & Sons Ltd.
Références
Paolucci S , Di Vita A , Massicci R , et al. Impact of participation on rehabilitation results: a multivariate study. Eur J Phys Rehabil Med. 2012;48:455-466.
Bachmann S , Finger C , Huss A , Egger M , Stuck AE , Clough-Gorr KM . Inpatient rehabilitation specifically designed for geriatric patients: systematic review and meta-analysis of randomised controlled trials. BMJ. 2010;340:c1718.
Gosman-Hedström G , Svensson E . Parallel reliability of the functional independence measure and the Barthel ADL index. Disabil Rehabilitation. 2000;22:702-715.
Hamilton BB , Laughlin JA , Fiedler RC , Granger CV . Interrater reliability of the 7-level functional independence measure (FIM). Scand J Rehabil Med. 1994;26:115-119.
Ottenbacher KJ , Hsu Y , Granger CV , Fiedler RC . The reliability of the functional independence measure: a quantitative review. Archives Phys Med Rehabilitation. 1996;77:1226-1232.
Saab A , Glass-Kaastra S , Young GB . Discharge destination from a rehabilitation unit after acute Ischemic stroke. Can J Neurol Sci. 2019;46:209-215.
Tsuchiya K , Fujita T , Sato D , et al. Post-stroke depression inhibits improvement in activities of daily living in patients in a convalescent rehabilitation ward. J Phys Ther Sci. 2016;28:2253-2259.
Shiraishi N , Mizutani C , Menjho M , et al. Comparison of activities of daily living for a convalescent rehabilitation ward and general ward for stroke patients. Jpn J Geriat. 2004;41:646-652.
Mutai H , Furukawa T , Araki K , Misawa K , Hanihara T . Factors associated with functional recovery and home discharge in stroke patients admitted to a convalescent rehabilitation ward. Geriatr Gerontol Int. 2012;12:215-222.
Maeshima S , Okamoto S , Okazaki H , et al. Potential factors, including activities of daily living, influencing home discharge for patients with putaminal haemorrhage. BMC Neurol. 2016;16:16.
Okamoto N , Masumi S , Yamada M , Arihisa E , Kodama T . Analysis of FIM factors affecting discharge to home from a recovery rehabilitation hospital. Rigakuryoho Kagaku. 2012;27:103-107.
Hamaoka K , Maeda R , Okabayashi M , et al. Functional independence measure reference values for the discharge to home of stroke patients. Rigakuryoho Kagaku. 2014;29:933-937.
Shinjo G , Otaka Y , Muraoka K , Ebata H , Liu M . Functional outcomes of rehabilitation in patients with subacute stroke on haemodialysis. J Rehabil Med. 2020;52:jrm00033.
Sansone GR , Alba A , Frengley JD . Analysis of FIM instrument scores for patients admitted to an inpatient cardiac rehabilitation program. Archives Phys Med Rehabilitation. 2002;83:506-512.
Cournan M . Use of the functional independence measure for outcomes measurement in acute inpatient rehabilitation. Rehabil Nurs. 2011;36:111-117.
Sandstrom R , Mokler PJ , Hoppe KM . Discharge destination and motor function outcome in severe stroke as measured by the functional independence measure/function-related group classification system. Archives Phys Med Rehabilitation. 1998;79:762-765.
Sawada Y , Suzuki Y , Maruo Y , Okajima S , Fukawa N , Fukuda K . Factors influencing outcomes for stroke rehabilitation patient. Rigakuryoho Kagaku. 2009;24:659-663.
Sasanuma N , Takahashi K , Itani Y , et al. Motor and cognitive function analysis for home discharge using the functional independence measure in patients undergoing cardiac rehabilitation at a long-term acute-care hospital. Eur J Phys Rehabil Med. 2015;51:781-792.
Sawada Y , Suzuki Y , Maruo Y , Okajima S , Fukuda K . Factors influencing outcomes in rehabilitation of stroke patients. Rigakuryoho Kagaku. 2010;25:965-968.
Mauthe RW , Haaf DC , Haya P , Krall JM . Predicting discharge destination of stroke patients using a mathematical model based on six items from the functional independence measure. Archives Phys Med Rehabilitation. 1996;77:10-13.
DʼSouza AN , Granger CL , Patrick CJ , Kay JE , Said CM . Factors associated with discharge destination in community-dwelling adults admitted to acute general medical units. J Geriatr Phys Ther. 2020.
Okuno Y , Miyasaka T , Dobashi K . Factors influencing the outcome of acute rehabilitation: functional independence measure assessment at discharge. J Phys Ther Sci. 2012;24:491-494.
Koval KJ , Maurer SG , Su ET , Aharonoff GB , Zuckerman JD . The effects of nutritional status on outcome after hip fracture. J Orthop Trauma. 1999;13:164-169.
Hagiwara N , Ibayashi S . Nutrition support team (NST) intervention for hip fracture in elderly patients over 90 years old-validation effect using the functional independence measure. Jpn J Geriatr. 2012;49:775-782.
Gariballa SE , Parker SG , Taub N , Castleden CM . Influence of nutritional status on clinical outcome after acute stroke. Am J Clin Nutr. 1998;68:275-281.
Kose E , Hirai T , Seki T , Hayashi H . The association of increased drugs use with activities of daily living and discharge outcome among elderly stroke patients. Int J Clin Pharm. 2018;40:599-607.
Kojima T , Akishita M , Nakamura T , et al. Polypharmacy as a risk for fall occurrence in geriatric outpatients. Geriatr Gerontol Int. 2012;12:425-430.
Gnjidic D , Hilmer SN , Blyth FM , et al. Polypharmacy cutoff and outcomes: five or more medicines were used to identify community-dwelling older men at risk of different adverse outcomes. J Clin Epidemiol. 2012;65:989-995.
Naruishi K , Kunita A , Nagata T , Takashiba S , Adachi S . Cut-off values of functional independence measure scores for discharge destination. Geriatrics Gerontology Int. 2015;15:670-671.
Bergés I-M , Kuo Y-F , Ostir GV , Gran ger CV , Graham JE , Ottenbacher KJ . Gender and ethnic differences in rehabilitation outcomes after hip-replacement surgery. Am J Phys Med Rehabil. 2008;87:567-572.
Vincent HK , Alfano AP , Lee L , Vincent KR . Sex and age effects on outcomes of total hip arthroplasty after inpatient rehabilitation. Archives Phys Med Rehabilitation. 2006;87:461-467.
Dutrieux R , Eijk M , Mierlo M , Heugten C , Visser-Meily J , Achterberg W . Discharge home after acute stroke: differences between older and younger patients. J Rehabil Med. 2016;48:14-18.
Sudou M , Morii H , Sakanaka M , et al. Introduction of pharmaceutical care and its effects in outpatients with cancer chemotherapy. Jpn J Pharmaceut Health Care Sci. 2013;39:77-84.
Nakajima K , Mano Y , Ohuchi K , et al. Role of pharmaceutical outpatient clinic in cancer patients and evaluation. Jpn J Pharmaceut Health Care Sci. 2012;38:599-608.
Ishibashi H . Rehabilitation after hip fractures. Rigakuryoho Kagaku. 2005;20:227-233.
Fujita H , Tsuchida N , Arahata K , Ishibashi H . Physical therapy for transcervical fracture in the elderly. Rigakuryoho Kagaku. 2002;17:149-156.
Ishidou Y , Koriyama C , Kakoi H , et al. Predictive factors of mortality and deterioration in performance of activities of daily living after hip fracture surgery in Kagoshima, Japan. Geriatr Gerontol Int. 2017;17:391-401.
Ministry of Health Labour and Welfare. Regional Medical Concept. https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000080850.html. Accessed April 12, 2021.