{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:29:04Z","timestamp":1785734944624,"version":"3.56.0"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2011,8,24]],"date-time":"2011-08-24T00:00:00Z","timestamp":1314144000000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2011,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To study the association of postacute care (PAC) settings and mortality outcome of patients who sustained an ischemic stroke.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>An integrated health care system in northern California.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Patients who sustained an acute ischemic stroke between 1996 and 2004, survived the initial acute care hospital stay, and received PAC services within 14 days of discharge (n = 16,538) and 61 days of discharge (n = 16,468).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>PAC rehabilitation ranked by resource level, that is, inpatient rehabilitation hospital (IRH), skilled nursing facility (SNF), home health (HH), and outpatient (OP) rehabilitation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measurements<\/jats:title><jats:p>One\u2010year mortality after acute care hospital discharge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The highest level of PAC services received within 14 days of acute care discharge was IRH for 5.6% of patients, SNF for 48.3% of patients, HH for 18.9% of patients, and OP for 27.3% of patients. The highest level of PAC services received within 61 days of acute care discharge was IRH for 10.9% of patients, SNF for 40.4% of patients, HH for 19.1% of patients, and OP for 29.6% of patients. Cox proportional hazard models showed that patients whose highest level of PAC service was provided by an IRH, through HH, or OP had a significantly better 1\u2010year survival than did those admitted to an SNF. The following factors were associated with a higher risk of 1\u2010year mortality: older age, male gender, African American ethnicity, history of previous stroke, higher Deyo\u2010Charlson comorbidity scores, a longer acute care hospital stay, and hospitalization in one remotely located health service area.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In the year after a stroke occurred, the rate of patient survival varied based on PAC rehabilitation services. Age, gender, race or ethnicity, history of a previous stroke, comorbid conditions, and service area also were significantly associated with 1\u2010year mortality after acute care discharge. Further investigation of the differences in mortality among PAC settings is indicated.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.pmrj.2011.04.028","type":"journal-article","created":{"date-parts":[[2011,8,25]],"date-time":"2011-08-25T19:42:03Z","timestamp":1314301323000},"page":"686-694","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Postacute Care and Ischemic Stroke Mortality: Findings From an Integrated Health Care System in Northern California"],"prefix":"10.1002","volume":"3","author":[{"given":"Hua","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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