Original Study| Volume 21, ISSUE 11, P1684-1688, November 2020

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Healthcare Utilization After Stroke: A 1-Year Prospective Study

  • Lisbeth Rosenbek Minet
    Address correspondence to Lisbeth Rosenbek Minet, PhD, Department of Rehabilitation, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark.
    Department of Clinical Research, University of Southern Denmark, Odense, Denmark

    Department of Rehabilitation, Odense University Hospital, Odense, Denmark

    The Health Research Center, UCL University College, Odense, Denmark
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  • Elizabeth Peterson
    Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
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  • Lena von Koch
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden

    Karolinska University Hospital, Stockholm, Sweden
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  • Charlotte Ytterberg
    Department of Clinical Research, University of Southern Denmark, Odense, Denmark

    Department of Rehabilitation, Odense University Hospital, Odense, Denmark

    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden

    Karolinska University Hospital, Stockholm, Sweden
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      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.


      A prospective study.

      Setting and Participants

      In total, 219 patients with stroke admitted to a hospital stroke unit were included.


      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.


      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.


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