LOS ANGELES, Jan. 24, 2018 -- Whether they are referred to home-based or outpatient rehabilitation after hospital discharge, many stroke patients don't receive rehabilitation services, according to preliminary research presented at the American Stroke Association's International Stroke Conference 2018, a world premier meeting dedicated to the science and treatment of cerebrovascular disease for researchers and clinicians.
"We don't know the exact reasons why these patients did not receive rehabilitation, but we assume it has to do with the co-pay that is associated with outpatient therapy services, even for those who have insurance. Home health, on the other hand, does not include co-pays, but there were still over half of those referred who did not receive it," said Cheryl Bushnell, M.D., M.H.S., study author and professor of Neurology and director, Wake Forest Baptist Stroke Center, Wake Forest Baptist Health in Winston Salem, North Carolina. "Clearly we need more research to understand these factors."
Timely rehabilitation after stroke is essential to optimize recovery. In this study, researchers evaluated whether patients discharged directly from the hospital to their homes experienced delays or gaps in care. In preliminary results from a pragmatic trial of COMprehensive Post-Acute Stroke Services (COMPASS), researchers called 369 participants thirty days after their discharge from the hospital. These patients included only those who had been referred to rehabilitation either at hospital discharge or at a follow-up clinic visit within 14 days of discharge.
Researchers found:
COMPASS researchers said a significant gap exists between referral to and receiving recommended stroke rehabilitation services. There may also be a disparity with out-patient therapy for non-white patients; however, these results will need to be replicated in larger trials.
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The Patient Centered Outcomes Research Institute funded the study.
Cheryl Bushnell, M.D., M.H.S., Wake Forest School of Medicine, Winston-Salem, North Carolina.
Presentation location: Room 502A
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