# Impact of Initial Stroke Rehabilitation Placement on Functional Recovery and Cost-effectiveness

> **NIH NIH K01** · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · 2020 · $136,350

## Abstract

PROJECT SUMMARY/ABSTRACT
Stroke is a leading cause of long-term disability in the United States. A large portion of the cost of stroke care is
rehabilitation. Providing optimal rehabilitation services aids in mitigating long-term disability for people after
stroke. There are a lack of clinical guidelines and poor understanding of long-term outcomes after discharge
from acute stroke care to an inpatient rehabilitation facility (IRF) or skilled nursing facility (SNF) for individuals
post-stroke. Our current healthcare climate requires faster decision making and early discharge, and the results
may be inappropriate discharge to an IRF or SNF, and thus not providing the patient with optimal outcomes. This
project will assess client (e.g., stroke severity, co-morbidities, and sociodemographic) and non-client (e.g., bed
availability and insurance) variables identified at the end of the acute hospital stay to determine which of these
variables are associated with discharge to an IRF or SNF (Research Aim 1). This project will follow the clients to
determine which of these client and non-client variables are associated with functional change—based on the
AM-PAC Inpatient “6-Clicks” Basic Mobility, Daily Activity, and Applied Cognitive tools at short-term (after
discharge from IRF or SNF) and long-term (6-months post-stroke; Research Aim 2). We will also determine cost-
effective strategies of placement into an IRF, to a SNF, versus a tailored, based on the client and non-client
variables identified in Aim 1 (Research Aim 3). We will use Markov modeling to predict related costs and quality-
adjusted life years using the Health-Related Quality of Life in Stroke Patients. Understanding the outcomes within
these similar post-acute care settings (IRF/SNF) for stroke is important in a rapidly evolving healthcare climate.
This study is significant because it will provide data about what initial client and non-client variables predict long-
term outcomes after discharge to an IRF or SNF and identify cost-effective strategies based on these variables.
These research activities provide experiential learning in support of my career development objectives. These
include increasing my knowledge and expertise in health services and policy research (Career Aim 1),
comparative effectiveness and outcome research (Career Aim 2), and cost-effective analyses (Career Aim 3).
This career development award will allow me to achieve my goal of becoming an independent stroke
rehabilitation science investigator. The ultimate outcome will be improved health outcomes for individuals post-
stroke, reduced disability, and reduced healthcare costs.

## Key facts

- **NIH application ID:** 9923680
- **Project number:** 5K01HD097280-02
- **Recipient organization:** UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH
- **Principal Investigator:** Heather A Hayes
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $136,350
- **Award type:** 5
- **Project period:** 2019-05-01 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9923680

## Citation

> US National Institutes of Health, RePORTER application 9923680, Impact of Initial Stroke Rehabilitation Placement on Functional Recovery and Cost-effectiveness (5K01HD097280-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9923680. Licensed CC0.

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