Healthcare Utilization After Stroke: A 1-Year Prospective Study |
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| Institution: | 1. Department of Clinical Research, University of Southern Denmark, Odense, Denmark;2. Department of Rehabilitation, Odense University Hospital, Odense, Denmark;3. The Health Research Center, UCL University College, Odense, Denmark;4. Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA;5. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden;6. Karolinska University Hospital, Stockholm, Sweden;1. Section of Infectious Disease, Department of Medicine, University of Chicago, Chicago, IL, USA;2. Department of Medicine, Section of Geriatrics and Palliative Medicine, University of Chicago, Chicago, IL, USA;3. Center for Transformative Care, University of Chicago Medicine, Chicago, IL, USA;4. Department of Infection Control and Prevention, University of Chicago, Chicago, IL, USA;1. Medicus Economics, Milton, MA, USA;2. Takeda Pharmaceuticals, Deerfield, IL, USA;3. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA;4. Parkinson''s Disease Research, Education and Clinical Center (PADRECC), Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA |
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| Abstract: | ObjectivesThis study was undertaken to investigate the predictive value of disease-related factors, contextual factors, and functioning on the use of healthcare for 1 year after stroke.DesignA prospective study.Setting and ParticipantsIn total, 219 patients with stroke admitted to a hospital stroke unit were included.MethodsData were obtained through medical records, structured interviews, and assessments. Multivariable regression analyses were used to explore the association between the independent variables (stroke severity, comorbidity, age, sex, civil status, private financing, sense of coherence, cognitive function, walking ability, social everyday activities prestroke, and recent fall) and the use of inpatient or outpatient care 0 to 3, 3 to 6 and 6 to 12 months after stroke.ResultsMean age of the participants was 70 years, 43% were women, and 71% experienced mild stroke severity. All participants received inpatient care at 0 to 3 months, about one-fifth used inpatient care at 3 to 6 or 6 to 12 months, and all received outpatient care all 3 time periods. Moderate-severe stroke (P < .001), a lower age (P = .002), and walking disability (P < .001) were associated with a higher use of inpatient care 0 to 3 months after stroke. Living alone (P = .025) and recent fall (P = .05) were associated with a higher use of inpatient care 3 to 6 months after stroke. None of the independent variables were associated with use of inpatient care 6 to 12 months. Moderate-severe stroke (0–3; 3–6 months: P < .001, 6–12 months: P = .004), a lower age (0–3 months: P = .002, 3–6 months: P = .001, 6–12 months: P = .006), and walking disability (P < .001) were associated with a higher use of outpatient care in all 3 time periods.Conclusions and ImplicationsModerate-severe stroke, lower age, and walking disability are important predictors of healthcare utilization after stroke. The findings inform efforts to identify and support people with stroke who have the potential for high healthcare utilization in the year post stroke. |
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| Keywords: | Stroke prospective healthcare utilization |
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