Factors associated with living setting at discharge from inpatient rehabilitation after acquired brain injury in Ontario, Canada.

Abstract

OBJECTIVE: This study examined factors associated with living setting of patients with acquired brain injury at discharge from inpatient rehabilitation. DESIGN: Retrospective cohort design. SUBJECTS/PATIENTS: Cohort of patients first identified in acute care with a diagnostic code of traumatic or non-traumatic brain injury who also subsequently received inpatient rehabilitation in Ontario, Canada for fiscal years 2003/2004 to 2005/2006. METHODS: Using logistic regression, we examined predisposing, need and enabling factors associated with living settings at discharge from inpatient rehabilitation (home/other versus residential care). Acute care and inpatient rehabilitation data were used. RESULTS: The majority of patients (83%) were discharged home after inpatient rehabilitation. Among ABI patients, those with longer lengths of stay and patients living alone and in non-home settings at admission were significantly more likely to be living in a residential care setting at discharge. Conversely, patients with higher total function scores from the FIMTM Instrument and those receiving informal support at discharge were significantly less likely to be living in a residential care setting at discharge. CONCLUSION: Our findings suggest that informal support influences service utilization and provide evidence for its importance at discharge with respect to living in the community. Prior living arrangement and functional outcome at discharge significantly predicted discharge destination. Improving physical function and providing needed supports at discharge may be factors important to reduce the demand for residential care facilities.