Deans' stroke musings: Abstract 26: Disparities in Post-Acute Stroke Rehabilitation Services Delivery: Preliminary Findings From the COMprehensive Post-Acute Stroke Services (COMPASS) Study

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, January 30, 2018

Abstract 26: Disparities in Post-Acute Stroke Rehabilitation Services Delivery: Preliminary Findings From the COMprehensive Post-Acute Stroke Services (COMPASS) Study

More excuses as to why stroke survivors don't get to 100% recovery.
http://stroke.ahajournals.org/content/49/Suppl_1/A26

, Cheryl D Bushnell, Amy M Pastva, Matthew A Psioda, , , , , Janet K Freburger, Pamela W Duncan

Stroke. 2018;49:A26

Abstract

Background: Timely rehabilitation after stroke is essential for optimizing recovery. Patients discharged home can experience unnecessary service delays and gaps in care. Our aim was to examine sociodemographic characteristics associated with receipt of rehabilitation services within 30 days after discharge home in stroke or transient ischemic attack (TIA) patients.

Methods: COMPASS is a cluster-randomized pragmatic trial measuring the effectiveness of the COMPASS model of care vs. usual care on functional status 90 days after stroke or TIA for patients discharged home. We analyzed data from 369 participants who enrolled in the intervention arm of the COMPASS trial, completed the post-acute clinic visit within 14 days, and the 30-day call between July 2016 and May 15, 2017. For those who were referred to rehabilitation services at hospital discharge or at the clinic visit, receipt of home health (HH) and outpatient (OP) rehabilitation services was reported by the participant during the 30-day call. Sociodemographic differences between those who did and did not receive these services were evaluated. We computed adjusted odds ratios with 95% confidence intervals using logistic regression to identify factors associated with receipt of rehabilitation services.

Results: Of the 369 patients, 176 (47.7%) had ascertainment of receipt of services. Of the 115 patients referred to HH, 50 (43.5%) received it, and of 85 patients referred to OP therapy, 29 (34.1%) received it. There were no statistically significant differences in sociodemographic characteristics related to receipt of HH, but non-whites were less likely (3 of 20, or 15%) than whites (25 of 64, 34.9%) to receive OP therapy. After adjustment for NIHSS, ambulatory status at hospital admission, and age, non-white participants had a 78% decreased odds (OR 0.22; 95% CI 0.05, 0.95; p=0.04) of receiving OP therapy.

Conclusion: These findings indicate that a significant gap exists between referral to and receipt of recommended post-acute stroke rehabilitation services. In addition, despite the small sample size, our results suggest that there may be a disparity in receipt of OP therapy for non-white patients relative to white patients.