Association of Caregiver Availability and Training With Patient Community Discharge After Stroke

Objective: To examine the association between committed caregivers and caregiver training with community discharge from inpatient rehabilitation after a stroke. Design: Secondary analysis of data extracted from electronic health records linked with the Uniform Data System for Medical Rehabilitation. Setting: Three hospital-based inpatient rehabilitation facilities (IRF) in a major metropolitan area. Participants: 1397 adult patients (mean ± SD age: 69.4 [13.5]; 724 men) transferred from an acute care setting to inpatient rehabilitation after an ischemic or hemorrhagic stroke (N=1397). Intervention: None. Main Outcome Measure: Community discharge from IRF. Results: 82.4% of patients had caregivers, 63.4% of patient caregivers received training at the IRF, and 79.5% had community discharge. After adjusting for age, stroke severity, functional status, and other social risk factors, having a committed caregiver and caregiver training were significantly associated with community discharge (odds ratio [OR]=7.80, 95% confidence interval [CI]: 5.03-12.10 and OR=4.89, 95% CI: 3.16-7.57, respectively). Conclusion: Caregivers increase a patient's likelihood of discharge from IRF; the added benefit of caregiver training needs to be further assessed, with essential elements prioritized prior to patients’ IRF discharge.