Effects of functional performance and national health insurance cost on length of hospitalization for postacute care in stroke: a retrospective observational study

BMC Neurol. 2023 Sep 29;23(1):343. doi: 10.1186/s12883-023-03396-z.

Abstract

Background: The postacute care for cerebrovascular disease (PAC-CVD) program was launched in Taiwan nearly a decade ago. However, no clear regulations regarding length of stay (LOS) in the program and extension standards exist. Thus, the allocation of limited medical resources such as hospital beds is a major issue.

Methods: This novel study retrospectively investigated the effects of functional performance and national health insurance (NHI) costs on PAC-CVD LOS. Data for 263 patients with stroke who participated in the PAC-CVD program were analysed. Hierarchical multiple regression was used to estimate the effects of functional performance and NHI costs on LOS at three time points: weeks 3, 6, and 9.

Results: At week 3, age, NHI costs, modified Rankin scale score, and Barthel index significantly affected LOS, whereas at week 6, age and NHI costs were significant factors. However, functional performance and NHI costs were not significant factors at week 9.

Conclusions: The study provides crucial insights into the factors affecting LOS in the PAC-CVD program, and the results can enable medical decision-makers and health care teams to develop inpatient rehabilitation plans or provide transfer arrangements tailored to patients. Specifically, this study highlights the importance of early functional recovery and consideration of NHI costs when managing LOS in the PAC-CVD program.

Keywords: Decision making; Disability; Health care allocation; Health policy; Healthcare costs; Postacute care; Stroke.

Publication types

  • Observational Study

MeSH terms

  • Hospitalization
  • Humans
  • Length of Stay
  • National Health Programs
  • Physical Functional Performance
  • Retrospective Studies
  • Stroke* / therapy
  • Subacute Care*