Really, you think access is the most important item that survivors care about? NO YOU ARE WRONG, TRY 100% RECOVERY. And I'm sure the goal-directed treatment is goals the therapist and doctor set, NOT THE SURVIVOR. Because you have to make sure the tyranny of low expectations can be met with the available therapy. You really would hate for stroke survivors to realize that their stroke medical 'professionals' know absolutely nothing about 100% recovery.
Access to rehabilitation for patients with stroke in Australia
Med J Aust 2019; 210 (1): 21-26. || doi: 10.5694/mja2.12034
Published online: 14 January 2019
Published online: 14 January 2019
Abstract
Objective: To
identify factors associated with receiving acute goal‐directed
treatment, being assessed for ongoing rehabilitation, and receiving
post‐acute rehabilitation after having a stroke.
Design: Retrospective analysis of National
Stroke Audit data for patients with acute stroke treated at Australian
hospitals during 1 September 2014 – 28 February 2015.
Setting, participants: 112 Australian hospitals that admit adults with acute stroke.
Main outcomes: Associations between patient‐related and organisational factors and the provision of rehabilitation interventions.
Results: Data for 3462 patients were
eligible for analysis; their median age was 74 years, 1962 (57%) were
men, and 2470 (71%) had received care(NOT RESULTS?) in a stroke unit. 2505 patients
(72%) received goal‐directed treatment during their acute admission; it
was not provided to 364 patients (10.5%) who were responsive, had not
fully recovered, and did not refuse treatment. Factors associated with
higher odds of receiving goal‐directed treatment included goal‐setting
with the patient and their family (odds ratio [OR], 6.75; 95% CI,
5.07–8.90) and receiving care in a stroke unit (OR, 2.08; 95% CI,
1.61–2.70). 1358 patients (39%) underwent further rehabilitation after
discharge from acute care; factors associated with receiving post‐acute
rehabilitation included care in a stroke unit (OR, 1.73; 95% CI,
1.34–2.22) and having an arm or speech deficit. Dementia was associated
with lower odds of receiving acute goal‐directed treatment (OR, 0.49;
95%, 0.33–0.73) and post‐acute rehabilitation (OR, 0.43; 95%,
0.30–0.61).
Conclusions: Access to stroke units and to
early and ongoing rehabilitation for patients after stroke can be
improved in Australia, both to optimise outcomes and to reduce the
burden of care on underresourced community and primary care providers.
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