Modelling clinical decision-making referral patterns to home-based or hospital-based stroke outpatient rehabilitation programs in London, Ontario: A prognostic model development study

The rehabilitation of stroke survivors is an ongoing process for months to years after the injury. Parkwood Institute in London, Ontario is an example of a model outpatient program recommended by the Canadian Stroke Best Practice Recommendations, as patients have access to hospital-based outpatient rehabilitation (Comprehensive Outpatient Rehabilitation Program (CORP)) and home-based rehabilitation (Community Stroke Rehabilitation Teams (CSRT)). However, the decision to refer to either outpatient service is ad hoc. This thesis explores if referrals to CORP or CSRT can be modelled through the development of a prognostic model. The model found that patients who have a higher number of comorbidities, live further away from Parkwood Institute, are older, have strokes of moderate severity, lower functional independence measure (FIM) scores and have reading comprehension difficulties are referred more often to CSRT. Patients with a caregiver, higher FIM scores, and auditory communication problems are more likely to be referred to CORP.

Name thesis:degree_name

M Sc

Discipline thesis:degree_discipline

Epidemiology and Biostatistics

Grantor dc:publisher

The University of Western Ontario

Year dc:date.issued

2019

Author dc:creator

• Iruthayarajah, Jerome

Advisors dc:contributor.advisor

• Speechley, Mark R
• Teasell, Robert W

• Stroke
• rehabilitation
• outpatient
• prediction model
• prognostic
• referral
• decision-making
• logistic regression

Language dc:language.iso

en_ca

Handle dc:identifier.uri

https://hdl.handle.net/20.500.14721/28748

OAI identifier oai:identifier

oai:uwo.scholaris.ca:20.500.14721/28748