Inequities in access to inpatient rehabilitation after stroke: an international scoping review

So rather than actually solving ANY of the problems in stroke, let's just review the access problems and not do one damn thing to help survivors recover. Who fucking cares about access? Survivors want results, deliver them. Does no one understand what survivors want?  They want 100% recovery, not the dumbed down goals your doctors and therapists suggest.
http://www.tandfonline.com/doi/abs/10.1080/10749357.2017.1366010

Elizabeth A. Lynch , Dominique A. Cadilhac, Julie A. Luker & Susan L. Hillier

Pages 1-8 | Received 09 Apr 2017, Accepted 05 Aug 2017, Published online: 23 Aug 2017

• Download citation
• http://dx.doi.org/10.1080/10749357.2017.1366010

Select Language​▼

Translator disclaimer

• 
  

Abstract

Background

Inequities in accessing inpatient rehabilitation after stroke have been reported in many countries and impact on patient outcomes.

Objective

To explore variation in international recommendations regarding which patients should receive inpatient rehabilitation after stroke and to describe reported access to rehabilitation.

Methods

A scoping review was conducted to identify clinical guidelines with recommendations regarding which patients should access inpatient rehabilitation after stroke, and data regarding the proportion of patients accessing stroke rehabilitation. Four bibliographic databases and grey literature were searched.

Results

Twenty-eight documents were included. Selection criteria for post-acute inpatient rehabilitation were identified for 14 countries or regions and summary data on the proportion of patients receiving inpatient rehabilitation were identified for 14 countries. In Australia, New Zealand, and the United Kingdom, it is recommended that all patients with stroke symptoms should access rehabilitation, whereas guidelines from the United States, Canada, and Europe did not consistently recommend rehabilitation for people with severe stroke. Access to inpatient rehabilitation ranged from 13% in Sweden to 57% in Israel. Differences in availability of early supported discharge/home rehabilitation programs and variations in reporting methods may influence the ability to reliably compare access to rehabilitation between regions.

Conclusion

Recommendations regarding which patients with moderate and severe strokes should access ongoing rehabilitation are inconsistent. Clinical practice guidelines from different countries regarding post-stroke rehabilitation do not always reflect the evidence regarding the likely benefits to people with stroke. Inequity in access to rehabilitation after stroke is an international issue.