Social Support and Actual Versus Expected Length of Stay in Inpatient Rehabilitation Facilities.
Zakkoyya H Lewis, Catherine Cooper Hay, James E Graham and 3 others
PMID 27373747WHAT IT FOUND
Almost half of stroke, lower extremity fracture, and joint replacement inpatients left earlier than expected.
Patients with no family or friend support were less likely to leave early in all groups, and more likely to stay longer in fracture or joint replacement.
Key findings
01Nearly half of patients in all three impairment groups were discharged more than one day earlier than expected.
02Compared with family or friend support, no social support was associated with lower odds of a short stay in all three groups and higher odds of a long stay in fracture and joint replacement.
03Paid or other support was associated with long stays only in joint replacement.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study used 2012 Medicare data, so it may not apply to other years. It included only patients with stroke, lower extremity fracture, or lower extremity joint replacement who lived at home before the impairment onset, and it excluded deaths, short-stay transfers, stays under 3 days or over 45 days, and missing social support. Social support was only marital status and living situation, not caregiver involvement or quality. The design is observational, so associations cannot show that social support caused a shorter or longer stay. The authors said an interaction term for motor function and comorbidity might better capture their combined effects.
Declared interests
The paper does not report author conflicts of interest. The publication types list NIH extramural and U.S. government, non-PHS research support.
The easy way to misread this
Do not read these associations as proof that arranging family or friend support will shorten a stay. The study measured social support only from marital status and living situation, and it did not measure what caregivers actually did.