Jan Stephen, Essue Beverley M, Glozier Nick, Lindley Richard, Li Qiang, Hackett Maree L
The George Institute for Global Health, PO Box M201, Missenden Road, Sydney, NSW 2050, Australia.
BMC Public Health. 2013 Sep 24;13:884. doi: 10.1186/1471-2458-13-884.
Stroke recovery is generally optimised through the provision of multidisciplinary rehabilitation. However not much is known about how equitably such services are utilised. This study examines the determinants of physiotherapy and speech therapy utilisation in rehabilitation within a cohort of young stroke survivors in Australia.
Psychosocial Outcomes in StrokE (POISE) was a three-year prospective observational study involving stroke survivors between the ages of 18 and 65 years recruited within 28 days of stroke. It was conducted in 20 stroke units in Australia. Participants were interviewed at 28 days (baseline), 6 and 12 months after stroke about their demographic and socioeconomic background, economic and health outcomes and the use of services. The primary outcome in this paper is utilisation of rehabilitation in the 12 months after stroke.
Of 414 participants, 254 (61%) used some rehabilitation in the 12 months post stroke. The strongest predictor of use of these rehabilitation services was dependency at 28 days, as assessed by need for assistance in activities of daily living (OR=33.1; p<0.0001). Other significant variables were two dimensions of social capital--an individuals' ability to make important decisions, which had a negative relationship (OR = 0.43; p=0.04) and number of close friends (OR= 1.042; p=0.02).
These findings demonstrate that socio-demographic factors exert little influence on the use of rehabilitation services in working age stroke patients and that the use of such services is primarily determined by 'need'. Such findings suggest that services are being provided equitably.
ANZCTRN12608000459325.
通常通过提供多学科康复治疗来优化中风恢复效果。然而，对于此类服务的公平利用情况知之甚少。本研究调查了澳大利亚一群年轻中风幸存者康复过程中物理治疗和言语治疗利用情况的决定因素。
中风心理社会结局（POISE）是一项为期三年的前瞻性观察性研究，涉及中风后28天内招募的18至65岁的中风幸存者。该研究在澳大利亚的20个中风单元进行。在中风后28天（基线）、6个月和12个月对参与者进行访谈，了解他们的人口统计学和社会经济背景、经济和健康结局以及服务使用情况。本文的主要结局是中风后12个月内的康复治疗利用情况。
在414名参与者中，254名（61%）在中风后12个月内使用了一些康复治疗。这些康复服务使用的最强预测因素是中风后28天的依赖程度，通过日常生活活动所需的帮助来评估（比值比=33.1；p<0.0001）。其他显著变量是社会资本的两个维度——个人做出重要决定的能力，呈负相关（比值比 = 0.43；p = 0.04）以及亲密朋友的数量（比值比 = 1.042；p = 0.02）。
这些发现表明，社会人口学因素对工作年龄中风患者康复服务的使用影响很小，此类服务的使用主要由“需求”决定。这些发现表明服务提供是公平的。
ANZCTRN12608000459325。
