Factors influencing home discharge after inpatient rehabilitation of older patients: a systematic review

BACKGROUND Although rehabilitation for older patients has the potential to improve function and prevent admission to nursing homes, returning home after discharge is not possible for all patients. Better understanding of patient factors related to discharge home may lead to more realistic rehabilitation goals, more targeted rehabilitation interventions and better preparation of both patient and informal caregiver for discharge. Various studies provided insight into factors related to home discharge after stroke rehabilitation, but we still lack insight into factors related to home discharge in non-stroke patients. Therefore, the aim of this review is to provide an overview of factors influencing home discharge in older non-stroke patients admitted to an inpatient rehabilitation unit. METHODS A systematic literature search was executed in the databases PubMed, EMBASE, CINAHL and Web of Science to retrieve articles published between January 2000 and October 2015. The search focused on factors related to home discharge after rehabilitation for older patients. Studies were included if home discharge after rehabilitation was assessed as an outcome measure and if the non-stroke population was, on average, 65 years or older and admitted to an inpatient rehabilitation unit. RESULTS Eighteen studies were included. The methodological quality was moderate to good in 15 studies. The factors significantly associated with home discharge are younger age, non-white ethnicity, being married, better functional and cognitive status, and the absence of depression. CONCLUSIONS Because various factors are significantly associated with home discharge of older non-stroke patients after rehabilitation, we recommend assessing these factors at admission to the rehabilitation unit. Further research into the factors that lack sufficient evidence concerning their association with home discharge is recommended.