Patient Factors Associated With Attendance at a Comprehensive Postacute Stroke Visit: Insight From the Vanguard Site.
Jacqueline Halladay, Cheryl Bushnell, Matthew Psioda and 5 others
PMID 33543066WHAT IT FOUND
Attendance at a postacute visit was associated with scheduling it before discharge, completing a 2-day call, having a primary care provider, and having stroke rather than TIA.
Distance did not matter at this single site.
Key findings
01Of 1300 eligible and enrolled patients, 822 (63.2%) completed the postacute COMPASS visit.
02In adjusted analysis, attendance was significantly associated with scheduling the visit at discharge, completing the 2-day call, having a primary care provider, and having stroke rather than TIA.
03Driving distance, including more than 60 miles or 96.6 km, was not associated with visit attendance.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study used one tertiary care center, so local staffing and outreach variation may have affected attendance. Stroke severity was missing for many patients, so number of therapy referrals was used as a stand-in. Having a primary care provider on record may have been newly arranged during discharge or the 2-day call, not an established relationship. The analysis reports associations, not proof that scheduling visits or making calls caused attendance. Missing data were imputed, but the paper notes that complete-case analysis can bias estimates.
The easy way to misread this
Do not read the scheduling and phone-call findings as proof that these actions cause higher attendance. The study observed associations at one site and did not assign patients to different discharge processes.