Predictors of access to healthcare services within 1 month after stroke in a developing country: A longitudinal prospective study

Soraia Micaela Silva; Tamires Mariana de Freitas Vieira Dutra; Marcela Aline Fernandes Braga; Edvânia Andrade de Moura Silva; Iza de Faria-Fortini; Christina Danielli Coelho de Morais Faria

doi:10.1002/pri.2000

Predictors of access to healthcare services within 1 month after stroke in a developing country: A longitudinal prospective study

Physiother Res Int. 2023 Mar 13:e2000. doi: 10.1002/pri.2000. Online ahead of print.

Authors

Soraia Micaela Silva¹, Tamires Mariana de Freitas Vieira Dutra², Marcela Aline Fernandes Braga¹, Edvânia Andrade de Moura Silva³, Iza de Faria-Fortini³, Christina Danielli Coelho de Morais Faria⁴

Affiliations

¹ Departament of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazi.
² Graduate Program in Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, Brazil.
³ Department of Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
⁴ Department of Physical Therapy, Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.

PMID: 36915963
DOI: 10.1002/pri.2000

Abstract

Background: 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.

Objective: To identify predictors of access to healthcare services within 1 month of hospital discharge in a developing country (Brazil).

Methods: 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%).

Results: 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.

Conclusions: 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.

Keywords: disability; health; healthcare services; stroke; stroke rehabilitation.

Abstract

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