Efficacy and Cost over 12 Hospitalization Weeks of Postacute Care for Stroke
Abstract
:1. Introduction
2. Materials and Methods
2.1. PAC-CVD Program
2.2. Study Design and Patients
2.3. Functional Performance Measures
2.4. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Functional Recovery and NHI Cost
3.2.1. Patients with PAC-CVD LOS of at Least 3 Weeks
3.2.2. Patients with a PAC-CVD LOS of at Least 6 Weeks
3.2.3. Patients with a PAC-CVD LOS of at Least 9 Weeks
3.2.4. Patients with a PAC-CVD LOS of 10–12 Weeks
3.2.5. Impact of Functional Performance on NHI Cost
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Mean (SD) or n (%) | |
---|---|---|
Demographics | ||
Age, years | 63.74 (13.08) | |
Sex | Female | 91 (34.6%) |
Male | 172 (65.4%) | |
Clinical Attributes | ||
Stroke Type | ||
Ischemic | 188 (71.5%) | |
Hemorrhagic | 75 (28.5%) | |
Hypertension | 247 (93.9%) | |
Coronary Artery Disease | 76 (28.9%) | |
Diabetes Mellitus | 112 (42.6%) | |
Hyperlipidemia | 121 (46.0%) | |
Previous Stroke | 53 (20.2%) | |
Common Risk Factors | ||
Smoking | 59 (22.4%) | |
Drinking | 29 (11.0%) | |
Prerehabilitation Functional Status | ||
mRS | 3.66 (0.47) | |
BI | 44.56 (22.23) | |
5MWS | 0.1 (0.24) | |
6MWD | 25.67 (67.64) | |
Medical Care of PAC-CVD Program | ||
PAC-CVD LOS, days | 32.57 (15.28) | |
Weeks of Hospitalization | ||
0–3 Weeks | 111 (42.2%) | |
4–6 Weeks | 126 (47.9%) | |
7–9 Weeks | 20 (7.6%) | |
10–12 Weeks | 6 (2.3%) | |
Cost of NHI, USD | 3189.95 (1501.07) |
0–3 Weeks Functional Status | |||
---|---|---|---|
Variables | W0 | W3 | p |
mRS | 3.66 (0.47) | 3.02 (0.90) | <0.001 *** |
BI | 44.56 (22.23) | 68.92 (24.40) | <0.001 *** |
5MWS | 0.1 (0.24) | 0.29 (0.45) | <0.001 *** |
6MWD | 25.67 (67.64) | 85.15 (126.87) | <0.001 *** |
Cost of NHI | |||
Admitted | 0–3 weeks | p | |
Cost of NHI, USD | - | 1895.31 (251.47) | - |
0–6 Weeks Functional Status | ||||||
---|---|---|---|---|---|---|
Variables | W0 | W3 | W6 | F | p | Pairwise Comparison |
mRS | 3.87 (0.33) | 3.51 (0.61) | 3.12 (0.73) | 131.88 *** | <0.001 | W0 > W3 a, W0 > W6 a, W3 > W6 a |
BI | 34.38 (18.44) | 56.58 (21.73) | 67.89 (20.62) | 327.51 *** | <0.001 | W6 > W3 a, W6 > W0 a, W3 > W0 a |
5MWS | 0.02 (0.10) | 0.14 (0.42) | 0.23 (0.34) | 28.38 *** | <0.001 | W6 > W3 a, W6 > W0 a, W3 > W0 a |
6MWD | 6.59 (40.77) | 32.97 (81.13) | 65.54 (101.28) | 54.60 *** | <0.001 | W6 > W3 a, W6 > W0 a, W3 > W0 a |
Cost of NHI | ||||||
Admitted | W3 | W6 | F | p | Pairwise Comparison | |
Cost of NHI, USD | - | 2014.74 (84.32) | 1843.27 (291.97) | 6344.74 *** | <0.001 | W3 > W6 a, W6 > W0 a, W3 > W0 a |
0–9 Weeks Functional Status | |||||||
---|---|---|---|---|---|---|---|
Variables | W0 | W3 | W6 | W9 | F | p | Pairwise Comparison |
mRS | 3.88 (0.33) | 3.73 (0.45) | 3.54 (0.51) | 2.96 (0.77) | 21.16 *** | <0.001 | W0 > W3, W0 > W6 a, W0 > W9 a, W3 > W6, W3 > W9 a, W6 > W9 a |
BI | 33.27 (16.55) | 51.35 (20.86) | 58.46 (19.17) | 74.62 (16.12) | 72.31 *** | <0.001 | W9 > W6 a, W9 > W3 a, W9 > W0 a, W6 > W3 a, W6 > W0 a, W3 > W0 a |
5MWS | <0.001 (<0.001) | 0.04 (0.14) | 0.07 (0.22) | 0.20 (0.28) | 9.86 *** | 0.001 | W9 > W6 a, W9 > W3 a, W9 > W0 a, W6 > W3, W6 > W0, W3 > W0 |
6MWD | <0.001 (<0.001) | 9.35 (37.59) | 21.98 (58.07) | 61.31 (104.13) | 7.66 ** | 0.004 | W9 > W6, W9 > W3 a, W9 > W0 a, W6 > W3, W6 > W0, W3 > W0 |
Cost of NHI | |||||||
Admitted | W3 | W6 | W9 | F | p | Pairwise Comparison | |
Cost of NHI, USD | - | 1993.31 (92.54) | 2060.84 (44.57) | 1928.40 (178.61) | 2487.77 *** | <0.001 | W6 > W9 a, W3 > W9, W9 > W0 a, W6 > W3 a, W6 > W0 a, W3 > W0 a |
9–12 Weeks Functional Status | |||||
---|---|---|---|---|---|
Variables | W9 | W12 | |||
Median (IQR) | Mean (SD) | Median (IQR) | Mean (SD) | p | |
mRS | 3 (0.25) | 3.17 (0.41) | 3 (1) | 2.67 (0.52) | 0.08 |
BI | 62.5 (13.75) | 63.33 (8.76) | 75 (16.25) | 77.50 (12.15) | 0.04 * |
5MWS | 0.05 (0.14) | 0.07 (0.08) | 0.17 (0.23) | 0.14 (0.12) | 0.07 |
6MWD | 0 (38.75) | 14.17 (22.45) | 59 (58.25) | 44.83 (30.92) | 0.04 * |
Cost of NHI during 10 to 12 weeks | |||||
Cost of NHI, USD | 1695.53 (264.65) |
Model Summary | |||||||
---|---|---|---|---|---|---|---|
Model | R | R2 | Adjusted R2 | R2 Change | F Change | Sig. F Change | Durbin-Watson |
1 | 0.208 | 0.043 | 0.036 | 0.043 | 5.858 | 0.003 | - |
2 | 0.263 | 0.069 | 0.032 | 0.026 | 0.879 | 0.535 | - |
3 | 0.407 | 0.166 | 0.119 | 0.097 | 7.175 | <0.001 | 1.552 |
Predictive Factor Input | |||||||
Model | Predictor | B | β | t | p | ||
1 | Constant | 59,524.25 | - | 24.14 | <0.001 | ||
Age | −75.79 | −0.133 | −2.162 | 0.032 * | |||
Sex | 2153.20 | 0.138 | 2.238 | 0.026 * | |||
2 | Constant | 56,156.05 | - | 15.95 | <0.001 | ||
Age | −74.55 | −0.131 | −1.874 | 0.062 | |||
Sex | 2576.49 | 0.165 | 2.487 | 0.014 * | |||
Stroke Type | 31.11 | 0.002 | 0.025 | 0.980 | |||
Previous Stroke | 1675.62 | 0.090 | 1.440 | 0.151 | |||
Hypertension | 2474.72 | 0.080 | 1.271 | 0.205 | |||
Coronary Artery Disease | 534.77 | 0.033 | 0.515 | 0.607 | |||
Diabetes Mellitus | −770.90 | −0.051 | −0.806 | 0.421 | |||
Hyperlipidemia | −687.58 | −0.046 | −0.669 | 0.504 | |||
Smoking | 334.69 | 0.019 | 0.257 | 0.797 | |||
Drinking | −2207.76 | −0.093 | −1.358 | 0.176 | |||
3 | Constant | 56,588.12 | - | 9.576 | <0.001 | ||
Age | −110.62 | −0.194 | −2.836 | 0.005 ** | |||
Sex | 2076.54 | 0.133 | 2.059 | 0.041 * | |||
Stroke Type | −554.81 | −0.034 | −0.468 | 0.640 | |||
Previous Stroke | 1849.77 | 0.100 | 1.660 | 0.098 | |||
Hypertension | 2391.33 | 0.077 | 1.268 | 0.206 | |||
Coronary Artery Disease | 496.01 | 0.030 | 0.494 | 0.622 | |||
Diabetes Mellitus | −531.20 | −0.035 | −0.579 | 0.563 | |||
Hyperlipidemia | −60.69 | −0.004 | −0.061 | 0.951 | |||
Smoking | 637.66 | 0.036 | 0.510 | 0.611 | |||
Drinking | −2144.91 | −0.090 | −1.379 | 0.169 | |||
mRS | 1571.62 | 0.189 | 1.764 | 0.079 | |||
BI | −40.13 | −0.132 | −1.352 | 0.178 | |||
5MWS | 124.40 | 0.008 | 0.073 | 0.942 | |||
6MWD | −2.06 | −0.035 | −0.328 | 0.743 |
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Chou, H.-Y.; Tsai, Y.-W.; Ma, S.-C.; Ma, S.-M.; Shih, C.-L.; Yeh, C.-T. Efficacy and Cost over 12 Hospitalization Weeks of Postacute Care for Stroke. Int. J. Environ. Res. Public Health 2023, 20, 1419. https://doi.org/10.3390/ijerph20021419
Chou H-Y, Tsai Y-W, Ma S-C, Ma S-M, Shih C-L, Yeh C-T. Efficacy and Cost over 12 Hospitalization Weeks of Postacute Care for Stroke. International Journal of Environmental Research and Public Health. 2023; 20(2):1419. https://doi.org/10.3390/ijerph20021419
Chicago/Turabian StyleChou, Hsiang-Yun, Ya-Wen Tsai, Shang-Chun Ma, Shang-Min Ma, Chia-Li Shih, and Chieh-Ting Yeh. 2023. "Efficacy and Cost over 12 Hospitalization Weeks of Postacute Care for Stroke" International Journal of Environmental Research and Public Health 20, no. 2: 1419. https://doi.org/10.3390/ijerph20021419