Development of a predictive model for the implementation of pre‐discharge visitation guidance for cerebrovascular patients admitted to recovery phase rehabilitation wards

<p>[Introduction] One of the methods of community collaboration in Comprehensive Rehabilitation word is pre‐discharge home guidance. Pre‐discharge guidance is a method of assistance necessary to promote cooperation between the hospital and long‐term care insurance staff when patients return home from the hospital. The professionals related to the recovery phase rehabilitation ward need to anticipate and coordinate the target patients for whom pre‐discharge home guidance is to be provided in order to provide planned discharge support.</p><p>[Objective] To develop a model to predict the implementation of pre‐discharge visitation guidance based on data obtained at the time of admission of patients with cerebrovascular disease admitted to a recovery rehabilitation ward.</p><p>[Methods] A retrospective study was conducted by dividing patients with cerebrovascular disorders into two groups: a group receiving home guidance and a group not receiving home guidance. Receiver Operating Characteristic curves were used to calculate cutoff values, sensitivity, specificity, and area under the curve for the variables that showed significant differences by logistic regression analysis.</p><p>[Results] Of the 137 patients with vascular disorders, 59 had pre‐discharge guidance and 78 did not. A standardized coefficient of -0.077 (odds ratio 0.926, 95% confidence interval 0.899-0.945) was selected for “exercise FIM" at admission as a factor predicting the implementation of pre‐discharge guidance. The cutoff value was 52.5 (sensitivity 0.932, specificity 0.397, AUC 0.833).</p><p>[Discussion] The model is useful in identifying patients with cerebrovascular disease who need home guidance based on criteria based on sensitivity and specificity, but its usefulness in selecting patients with cerebrovascular disease who do not need home guidance is limited.</p>