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Title: Inequities in access to inpatient rehabilitation after stroke: an international scoping review.
Austin Authors: Lynch, Elizabeth A;Cadilhac, Dominique A;Luker, Julie A;Hillier, Susan L
Affiliation: Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
Stroke Division, The Florey Institute of Neuroscience and Mental Health , Heidelberg, Victoria, Australia
NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery, Melbourne, Australia
Adelaide Nursing School, University of Adelaide, Australia
Stroke and Ageing Research Centre, Department of Medicine, Monash University, Melbourne, Australia
Issue Date: Dec-2017
Date: 2017-08-23
Publication information: Topics in Stroke Rehabilitation 2017; 24(8): 619-626
Abstract: Background Inequities in accessing inpatient rehabilitation after stroke have been reported in many countries and impact on patient outcomes. Objective To explore variation in international recommendations regarding which patients should receive inpatient rehabilitation after stroke and to describe reported access to rehabilitation. Methods A scoping review was conducted to identify clinical guidelines with recommendations regarding which patients should access inpatient rehabilitation after stroke, and data regarding the proportion of patients accessing stroke rehabilitation. Four bibliographic databases and grey literature were searched. Results Twenty-eight documents were included. Selection criteria for post-acute inpatient rehabilitation were identified for 14 countries or regions and summary data on the proportion of patients receiving inpatient rehabilitation were identified for 14 countries. In Australia, New Zealand, and theĀ United Kingdom, it is recommended that all patients with stroke symptoms should access rehabilitation, whereas guidelines from the United States, Canada, and Europe did not consistently recommend rehabilitation for people with severe stroke. Access to inpatient rehabilitation ranged from 13% in Sweden to 57% in Israel. Differences in availability of early supported discharge/home rehabilitation programs and variations in reporting methods may influence the ability to reliably compare access to rehabilitation between regions. Conclusion Recommendations regarding which patients with moderate and severe strokes should access ongoing rehabilitation are inconsistent. Clinical practice guidelines from different countries regarding post-stroke rehabilitation do not always reflect the evidence regarding the likely benefits to people with stroke. Inequity in access to rehabilitation after stroke is an international issue.
DOI: 10.1080/10749357.2017.1366010
ORCID: 0000-0001-8756-1051
Journal: Topics in Stroke Rehabilitation
PubMed URL: 28835194
Type: Journal Article
Subjects: Stroke
clinical practice guideline
Appears in Collections:Journal articles

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