Silva Soraia Micaela, Dutra Tamires Mariana de Freitas Vieira, Braga Marcela Aline Fernandes, Silva Edvânia Andrade de Moura, de Faria-Fortini Iza, Faria Christina Danielli Coelho de Morais
Departament of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazi.
Graduate Program in Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, Brazil.
Physiother Res Int. 2023 Mar 13:e2000. doi: 10.1002/pri.2000.
Globally, people with disabilities face difficulties accessing care, resulting in worse health outcomes and higher healthcare costs. However, information regarding access to healthcare services for stroke survivors in developing countries is scarce.
To identify predictors of access to healthcare services within 1 month of hospital discharge in a developing country (Brazil).
For six months, individuals from a stroke unit, aged ≥20 years, after their first stroke and without previous disability, were included and evaluated at hospital discharge for socio-demographic (sex, age, education, and socio-economic level) and clinical-functional (severity of stroke and level of disability) characteristics. The number and type of referrals to healthcare services provided by hospital staff were also recorded. One month after hospital discharge, data regarding access to healthcare services obtained by the subjects were collected. The Wilcoxon test was used to compare the number of referrals and access to healthcare services obtained by the subjects. To identify the predictors of access, a binary logistic regression was used (α = 5%).
A total of 78 individuals were evaluated one month after hospital discharge, all with at least one referral. The total access to healthcare services within 1 month of stroke was significantly lower than the total number of referrals (p < 0.001). Sex (odds ratios (OR) = 18.92; p = 0.01) and educational level (OR = 1.48; p = 0.04) were significant predictors of access.
Being female and having low education levels were predictors of access to healthcare services within 1 month of stroke in a developing country. In addition, the access was below expectations, compromising the integrality of care and national and international recommendations, which is a concern given the need for early care to obtain better results in health and functional outcomes.
在全球范围内，残疾人在获得医疗服务方面面临困难，这导致了更差的健康结果和更高的医疗成本。然而，关于发展中国家中风幸存者获得医疗服务的信息却很匮乏。
确定在一个发展中国家（巴西）中风幸存者出院后1个月内获得医疗服务的预测因素。
连续6个月纳入来自中风单元、年龄≥20岁、首次中风且既往无残疾的患者，并在出院时对其社会人口学特征（性别、年龄、教育程度和社会经济水平）和临床功能特征（中风严重程度和残疾水平）进行评估。同时记录医院工作人员提供的医疗服务转诊数量和类型。出院1个月后，收集受试者获得医疗服务的数据。采用Wilcoxon检验比较受试者的转诊数量和获得医疗服务的情况。为了确定获得医疗服务的预测因素，使用二元逻辑回归分析（α = 5%）。
出院1个月后共评估了78例患者，所有患者至少有一次转诊。中风后1个月内获得医疗服务的总数显著低于转诊总数（p < 0.001）。性别（比值比（OR）= 18.92；p = 0.01）和教育程度（OR = 1.48；p = 0.04）是获得医疗服务的显著预测因素。
在一个发展中国家，女性和低教育水平是中风后1个月内获得医疗服务的预测因素。此外，获得医疗服务的情况低于预期，这损害了护理的完整性以及国家和国际建议，鉴于需要早期护理以获得更好的健康和功能结果，这令人担忧。
