Factors influencing post discharge activities of daily living in patients receiving rehabilitation in acute care hospital

Post-discharge functional outcomes in patients undergoing acute rehabilitation-especially regarding activities of daily living (ADL) and instrumental activities of daily living (IADL)-remain inadequately understood. The combined effects of demographic factors and in-hospital variables on ADL and IADL status at discharge has not been clearly defined. This study aimed to clarify these associations to support effective discharge planning and post-discharge care strategies. We retrospectively analyzed 309 adult patients who received rehabilitation in an acute care hospital in Japan between April and September 2016. Patients who underwent only assessments, were pediatric, deceased, or did not receive rehabilitation were excluded. Demographic data and Barthel Index scores at rehabilitation initiation and discharge were extracted. Post-discharge ADL and IADL status were assessed approximately 1.5-2 years later using a questionnaire based on the Frenchay Activities Index (FAI). Among the 309 patients, 57 were transferred, 249 discharged home, and 3 institutionalized. ADL and IADL scores were significantly higher in the home discharge group. Higher ADL scores at discharge and post-discharge were independently associated with higher FAI scores, underscoring the importance of ADL independence for post-discharge IADL recovery. Addressing ADL limitations and optimizing rehabilitation may enhance IADL outcomes and support independent living after discharge.