Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/22173
Title: Patient and service factors associated with referral and admission to inpatient rehabilitation after the acute phase of stroke in Australia and Norway.
Authors: Labberton, Angela S;Barra, Mathias;Rønning, Ole Morten;Thommessen, Bente;Churilov, Leonid;Cadilhac, Dominique A;Lynch, Elizabeth A
Affiliation: Health Services Research Unit, Akershus University Hospital, PO Box 1000, 1478, Lørenskog, Norway
NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Newcastle, Australia
NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Heidelberg, Victoria, Australia
Centre for Connected Care, Oslo University Hospital, Oslo, Norway
Institute of Clinical Medicine, University of Oslo, Oslo, Norway
Department of Neurology, Akershus University Hospital, Lørenskog, Norway
Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Stroke Division, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg, Victoria, Australia
Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
Adelaide Nursing School, University of Adelaide, Adelaide, Australia
Issue Date: 21-Nov-2019
EDate: 2019
Citation: BMC health services research 2019-11-21; 19(1): 871
Abstract: Unequal access to inpatient rehabilitation after stroke has been reported. We sought to identify and compare patient and service factors associated with referral and admission to an inpatient rehabilitation facility (IRF) after acute hospital care for stroke in two countries with publicly-funded healthcare. We compared two cohorts of stroke patients admitted consecutively to eight acute public hospitals in Australia in 2013-2014 (n = 553), and to one large university hospital in Norway in 2012-2013 (n = 723). Outcomes were: referral to an IRF; admission to an IRF if referred. Logistic regression models were used to identify and compare factors associated with each outcome. Participants were similar in both cohorts: mean age 73 years, 40-44% female, 12-13% intracerebral haemorrhage, ~ 77% mild stroke (National Institutes of Health Stroke Scale < 8). Services received during the acute admission differed (Australia vs. Norway): stroke unit treatment 82% vs. 97%, physiotherapy 93% vs. 79%, occupational therapy 83% vs. 77%, speech therapy 78% vs. 13%. Proportions referred to an IRF were: 48% (Australia) and 37% (Norway); proportions admitted: 35% (Australia) and 28% (Norway). Factors associated with referral in both countries were: moderately severe stroke, receiving stroke unit treatment or allied health assessments during the acute admission, living in the community, and independent pre-stroke mobility. Directions of associations were mostly congruent; however younger patients were more likely to be referred and admitted in Norway only. Models for admission among patients referred identified few associated factors suggesting that additional factors were important for this stage of the process. Similar factors were associated with referral to inpatient rehabilitation after acute stroke in both countries, despite differing service provision and access rates. Assuming it is not feasible to provide inpatient rehabilitation to all patients following stroke, the criteria for the selection of candidates need to be understood to address unwanted biases.
URI: http://ahro.austin.org.au/austinjspui/handle/1/22173
DOI: 10.1186/s12913-019-4713-x
ORCID: 0000-0002-0047-7103
0000-0002-9807-6606
PubMed URL: 31752874
Type: Journal Article
Subjects: Health services
Referral and consultation
Rehabilitation
Stroke
Appears in Collections:Journal articles

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