To determine the utilization rate of a home-based rehabilitation program following an inpatient rehabilitation stay, and to investigate the profile of users.
Observational study SETTING: Inpatient rehabilitation facility in a tertiary hospital PARTICIPANTS: Older patients (N=1,913) discharged home between June 2018 and May 2021, after an inpatient rehabilitation stay.
N/A MAIN OUTCOME MEASURE: Discharge to home-based rehabilitation RESULTS: Over the study period, 296 (15.5%) patients were discharged to home-based rehabilitation. Compared to the others, home-based rehabilitation patients were more frequently women (69.6% vs 61.5%, p=.008), and admitted after orthopedic surgery (elective or for fracture) (30.1% vs 16.1%, p<.001). They had worse functional performance at admission (mean FIM self-care score: 27.8±7.3 vs 30.8±6.7, p<.001), but greater gain in self-care during their inpatient stay (5.0±4.8 vs 4.4±4.7, p=.038). In multivariable analysis, being a woman (adjOR 1.36; 95%CI 1.01-1.82, p=.040), being admitted after orthopedic surgery (adjOR 2.32; 95%CI 1.64-3.27, p<.001), being admitted for gait disorders or falls (adjOR 1.38; 95%CI 1.01-1.88, p=.039), and showing greater gain in mobility during the inpatient stay (adjOR 1.12; 95%CI 1.07-1.17, p<.001) remained associated with discharge to home-based rehabilitation. In contrast, higher mobility at discharge decreased the odds of discharge to home-based rehabilitation (adjOR 0.87; 95%CI 0.83-0.91, p<.001).
One in six patients benefited from home-based rehabilitation after their inpatient stay. Although these patients had poorer functional performance at admission and discharge, they showed greater mobility improvement during their inpatient stay, suggesting that their good recovery potential was a key determinant of their orientation toward home-based rehabilitation.