Abstract
The events during a patient’s transition from hospital to home or rehabilitation facility can greatly impact a patient’s recovery process. This dissertation defines the role of patient-perceived sufficient discharge education and communication (SDEC) (i.e., sufficient diet education, sufficient toxic habit cessation education, if applicable, and a scheduled medical appointment at discharge) on post-stroke healthy behavior changes and death or readmission among patients in the Transitions of Care Stroke Disparities Study (TCSDS), a prospective registry-derived observational study, conducted in 10 comprehensive stroke centers in Florida (2018-2023).
Our study described the characteristics of patients who reported receiving sufficient education and communication (SDEC) at discharge and subsequently determined if SDEC predicts self-reported post-discharge behavior changes. Adequate transition of care (ATOC) is defined by the patient's achievement of at least 75% of recommended positive behaviors and activities within 30 days post-stroke hospitalization. Multivariable logistic regression models were used to show the association between SDEC and ATOC in the overall TCSD-S sample (N=1,151, Average Age 64+/-14 years, 57% Men, 54% non-Hispanic White, 23% non-Hispanic Black, 23% Hispanic) and stratified by race/ethnicity. We found that patients reporting SDEC had an increased likelihood of accomplishing ATOC when compared to patients not reporting SDEC overall and among non-Hispanic Whites and Non-Hispanic Blacks, but not among Hispanics.
The last study measures the association between SDEC and all-cause death or readmission within 90 days post-stroke discharge, overall and stratified by race/ethnicity. 90-day death or readmission was highest among non-Hispanic Black patients when compared to other groups. We found that SDEC was associated with reduced death or readmission within 90 days post-stroke discharge among non-Hispanic Black patients but not in the overall TCSD-S nor among non-Hispanic Whites and Hispanics.