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Referral-based transition to subsequent rehabilitation at home after stroke: one-year outcomes and use of healthcare services

BACKGROUND: There is a lack of knowledge about patients’ journeys across the stroke care continuum, especially regarding the transition from inpatient to outpatient care and rehabilitation. Therefore, the aim of the present study was to explore and describe patterns of healthcare use over a one-year...

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Autores principales: Lindblom, Sebastian, Tistad, Malin, Flink, Maria, Laska, Ann Charlotte, von Koch, Lena, Ytterberg, Charlotte
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9066723/
https://www.ncbi.nlm.nih.gov/pubmed/35505404
http://dx.doi.org/10.1186/s12913-022-08000-7
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author Lindblom, Sebastian
Tistad, Malin
Flink, Maria
Laska, Ann Charlotte
von Koch, Lena
Ytterberg, Charlotte
author_facet Lindblom, Sebastian
Tistad, Malin
Flink, Maria
Laska, Ann Charlotte
von Koch, Lena
Ytterberg, Charlotte
author_sort Lindblom, Sebastian
collection PubMed
description BACKGROUND: There is a lack of knowledge about patients’ journeys across the stroke care continuum, especially regarding the transition from inpatient to outpatient care and rehabilitation. Therefore, the aim of the present study was to explore and describe patterns of healthcare use over a one-year period, health outcomes at 3 and 12 months for patients following a referral-based transition to subsequent rehabilitation in the home, and the caregiver burden on their significant others. A further aim was to explore factors associated with the use of rehabilitation and healthcare after the referral-based transition to continued rehabilitation in the home for people recovering from a stroke. METHODS: Data regarding healthcare use during the first 12 months post-stroke was collected from the Region Stockholm computerized register. Data on patient characteristics, disease-related data, and functioning were retrieved drawn from medical records and questionnaires. Descriptive statistics were used to present healthcare use, participants’ characteristics, disease-related data, and patient functioning. Multivariable regression models were created to explore associations between the total number of outpatient contacts, total visits with the neurorehabilitation team, and the independent variables. RESULTS: The mean age for the 190 participants was 73 years for men and 78 years for women. Twenty-one participants (11%) had an acute rehospitalization within 30 days after discharge, and 41 participants (21%) were re-hospitalized within 90 days. Twenty-two (12%) of the participants had no visits with the neurorehabilitation team, 73 (39%) participants had 1–3 visits, 57 (30%) had 4–16 visits, and 38 (20%) had ≥17 visits. Female sex and length of hospital stay were associated with a higher number of visits with the neurorehabilitation team. Living alone, higher self-rated recovery, and being able to walk independently were associated with a lower number of visits with the neurorehabilitation team. Female sex, having home help services before the stroke, longer length of hospital stay, and more comorbidities were associated with a higher number of outpatient contacts. CONCLUSIONS: The findings indicate that there is no generic pattern of healthcare use during the first-year post-stroke in patients receiving referral-based transition to continued rehabilitation in the home. The different patterns of healthcare use seemed to mirror the participants’ level of functioning. However, there is a need to further investigate how follow-up and rehabilitation correspond to the needs of patients and their significant others in the short- and long-term perspective. TRIAL REGISTRATION: ClinicalTrials.gov, registration number: NCT02925871. Date of registration: October 6, 2016.
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spelling pubmed-90667232022-05-04 Referral-based transition to subsequent rehabilitation at home after stroke: one-year outcomes and use of healthcare services Lindblom, Sebastian Tistad, Malin Flink, Maria Laska, Ann Charlotte von Koch, Lena Ytterberg, Charlotte BMC Health Serv Res Research BACKGROUND: There is a lack of knowledge about patients’ journeys across the stroke care continuum, especially regarding the transition from inpatient to outpatient care and rehabilitation. Therefore, the aim of the present study was to explore and describe patterns of healthcare use over a one-year period, health outcomes at 3 and 12 months for patients following a referral-based transition to subsequent rehabilitation in the home, and the caregiver burden on their significant others. A further aim was to explore factors associated with the use of rehabilitation and healthcare after the referral-based transition to continued rehabilitation in the home for people recovering from a stroke. METHODS: Data regarding healthcare use during the first 12 months post-stroke was collected from the Region Stockholm computerized register. Data on patient characteristics, disease-related data, and functioning were retrieved drawn from medical records and questionnaires. Descriptive statistics were used to present healthcare use, participants’ characteristics, disease-related data, and patient functioning. Multivariable regression models were created to explore associations between the total number of outpatient contacts, total visits with the neurorehabilitation team, and the independent variables. RESULTS: The mean age for the 190 participants was 73 years for men and 78 years for women. Twenty-one participants (11%) had an acute rehospitalization within 30 days after discharge, and 41 participants (21%) were re-hospitalized within 90 days. Twenty-two (12%) of the participants had no visits with the neurorehabilitation team, 73 (39%) participants had 1–3 visits, 57 (30%) had 4–16 visits, and 38 (20%) had ≥17 visits. Female sex and length of hospital stay were associated with a higher number of visits with the neurorehabilitation team. Living alone, higher self-rated recovery, and being able to walk independently were associated with a lower number of visits with the neurorehabilitation team. Female sex, having home help services before the stroke, longer length of hospital stay, and more comorbidities were associated with a higher number of outpatient contacts. CONCLUSIONS: The findings indicate that there is no generic pattern of healthcare use during the first-year post-stroke in patients receiving referral-based transition to continued rehabilitation in the home. The different patterns of healthcare use seemed to mirror the participants’ level of functioning. However, there is a need to further investigate how follow-up and rehabilitation correspond to the needs of patients and their significant others in the short- and long-term perspective. TRIAL REGISTRATION: ClinicalTrials.gov, registration number: NCT02925871. Date of registration: October 6, 2016. BioMed Central 2022-05-03 /pmc/articles/PMC9066723/ /pubmed/35505404 http://dx.doi.org/10.1186/s12913-022-08000-7 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Lindblom, Sebastian
Tistad, Malin
Flink, Maria
Laska, Ann Charlotte
von Koch, Lena
Ytterberg, Charlotte
Referral-based transition to subsequent rehabilitation at home after stroke: one-year outcomes and use of healthcare services
title Referral-based transition to subsequent rehabilitation at home after stroke: one-year outcomes and use of healthcare services
title_full Referral-based transition to subsequent rehabilitation at home after stroke: one-year outcomes and use of healthcare services
title_fullStr Referral-based transition to subsequent rehabilitation at home after stroke: one-year outcomes and use of healthcare services
title_full_unstemmed Referral-based transition to subsequent rehabilitation at home after stroke: one-year outcomes and use of healthcare services
title_short Referral-based transition to subsequent rehabilitation at home after stroke: one-year outcomes and use of healthcare services
title_sort referral-based transition to subsequent rehabilitation at home after stroke: one-year outcomes and use of healthcare services
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9066723/
https://www.ncbi.nlm.nih.gov/pubmed/35505404
http://dx.doi.org/10.1186/s12913-022-08000-7
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