Abstract
Objectives
This 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.
Design
A prospective study.
Setting and Participants
In total, 219 patients with stroke admitted to a hospital stroke unit were included.
Methods
Data 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.
Results
Mean 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 Implications
Moderate-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.
Keywords
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Article info
Publication history
Published online: July 12, 2020
Footnotes
Funding support was provided by Swedish Research Council (2007- 3087 and 2013-2806), Swedish Stroke Association, regional agreement on medical training and clinical research, Stockholm County Council, Karolinska Institutet (20060700), and Odense University Hospital Research Council (6075024).
Sponsors had no role in the design, methods, subject recruitment, data collections, analysis, or preparation of the report.
The authors declare no conflicts of interest.
Identification
Copyright
© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
