Measuring stroke outcomes for 74 501 patients using linked administrative data: System‐wide estimates and validation of ‘home‐time’ as a surrogate measure of functional status

Aims Administrative data offer cost‐effective, whole‐of‐population stroke surveillance yet the lack of validated measures of functional status is a shortcoming. The number of days spent living at home after stroke (‘home‐time’) is a patient‐centred outcome that can be objectively ascertained from administrative data. Population‐based validation against both severity and outcome measures and for all subtypes is lacking. We aimed to report representative ‘home‐time’ estimates and validate ‘home‐time’ as a surrogate measure of functional status after stroke. Methods Stroke hospitalisations from a state‐wide census in New South Wales, Australia, from January 1, 2005 to March 31, 2014 were linked to prehospital data, poststroke admissions and deaths. We correlated 90‐day ‘home‐time’ with Glasgow Coma Scale (GCS) scores, measured upon a patient's initial contact with paramedics and Functional Independence Measure (FIM) scores, measured upon entry to rehabilitation after the acute hospital stroke admission. Negative binomial regressions identified predictors of ‘home‐time’. Results Patients with stroke (N = 74 501) spent a median of 53 days living at home 90 days after the event. Median ‘home‐time’ was 60 days after ischaemic stroke, 49 days after subarachnoid haemorrhage and 0 days after intracerebral haemorrhage. GCS and FIM scores significantly correlated with ‘home‐time’ (P