A Comparison of Acute Ischemic Stroke Patients Discharged to Inpatient Rehabilitation vs a Skilled Nursing Facility: The Paul Coverdell National Acute Stroke Program.

Hospitals joined the registry voluntarily, so the results may not represent all acute ischemic stroke patients in the United States. Hospitals may not have submitted data consistently across years, which could bias the sample. The study did not know whether validated decision tools were used to choose the level of care at discharge, even though it noted that 43.1% of patients were discharged to rehabilitation. Aside from insurance status, the registry did not capture social determinants or patient preferences that may have affected discharge. The registry did not record why insurance status led to discharge to inpatient rehab or a skilled nursing facility. The outcome measured was discharge destination, not later function or rehabilitation outcomes, so the study cannot show which setting was better.

The Paul Coverdell National Acute Stroke Program is funded by the Centers for Disease Control and Prevention. The supplied text does not give an author conflict-of-interest statement.

Do not read these discharge patterns as evidence that inpatient rehab is better than skilled nursing care. The study compared where patients were discharged, not how they recovered, and it cannot show why those groups were less likely to reach inpatient rehab.