Psychosocial Factors Associated with Prolonged Length of Stay in Acquired Brain Injury Rehabilitation: A Retrospective Cohort Study

Abstract

Objective: In a climate of rising healthcare costs and increasing pressure to reduce inpatient length of stay, hospitals must balance their role as care providers with that as resource stewards. There is a need to understand what factors are associated with patients staying beyond rehabilitation length of stay targets. The aim of this study was to determine psychosocial patient factors that are identifiable on admission that influence length of stay targets in acquired brain injury rehabilitation.Methods: A retrospective case series of 167 inpatients with acquired brain injury was conducted at an urban, academic rehabilitation hospital. A total of 29 factors were used for data analysis. Logistic and multiple linear regression analysis was utilized to determine if any patient factors were associated with patients exceeding their length of stay targets.Results: Premorbid communal living status (e.g. group home) was associated with an odds ratio of 14.67 of exceeding length of stay target. Patients who did not drive prior to their admission had an odds ratio of 2.63 of exceeding their length of stay target. Conclusion: Premorbid communal living and premorbid non-driving status are predictors of patients with acquired brain injuries exceeding target rehabilitation length of stay. These findings may help acquired brain injury rehabilitation programmes plan for the needs of and advocate for patients. LAY ABSTRACTIn the setting of rising healthcare costs, there is a need to understand which patient factors most affect why patients stay longer than anticipated in hospital. The aim of this study was to determine what non-medical factors affect rehabilitation length of stay in patients after brain injuries. A study of 167 patients with brain injuries was conducted at a rehabilitation hospital to determine if any patient factors were associated with patient hospital length of stay. The results show that patients who lived in communal environments, such as group homes, had 14.67 times the risk of exceeding their length of stay target compared to all other living arrangements. Patients who did not drive prior to their admission had 2.63 times the risk of exceeding their length of stay target compared to drivers. In our study, only patient living environments and driving status were predictors of meeting length of stay targets. These findings may help brain injury rehabilitation programmes plan for the needs of and advocate for their patients.