Effects of Social Determinants of Health on Stroke Survivor Discharge Location from an Acute Comprehensive Stroke Center

Objective This study aimed to assess the influence of social determinants of health on discharge location after an acute care hospital admission due to stroke. Design Retrospective analyses assessed electronic medical records (EMR) from an acute facility in North Carolina dating from November 20, 2014, to December 29, 2019 (N = 4,603). All subjects were diagnosed with stroke and received at least one physical therapy session. Multinomial stepwise logistic regression assessed the clinical and demographic factors associated with being discharged to each home care with services, skilled nursing facilities, or inpatient rehabilitation in comparison to home care without services. Results After accounting for clinical variables, being younger, having a significant other, holding private insurance, being female, and being of Hispanic ethnicity were associated with a greater probability of being discharged to home care without services. Compared to White patients, Black patients were more likely to be discharged to home care with services than home care without services. Intraclass correlations indicated that zip code of residence may influence likelihood of being discharged to a skilled nursing facility. Conclusion This analysis demonstrates that social determinants of health are associated with discharge location.

Duke Scholars

Author Tiffany Adams Orthopaedic Surgery, Physical Therapy