IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v18y2021i14p7696-d597631.html
   My bibliography  Save this article

Multidisciplinary Care after Acute Care for Stroke: A Prospective Comparison between a Multidisciplinary Post-Acute Care Group and a Standard Group Matched by Propensity Score

Author

Listed:
  • Chong-Chi Chiu

    (School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
    Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan)

  • Hsiu-Fen Lin

    (Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
    Department of Neurology, Kaohsiung Medical University, Kaohsiung 80708, Taiwan)

  • Ching-Huang Lin

    (Division of Neurology, Kaohsiung Veterans General Hospital, Kaohsiung 81341, Taiwan)

  • Hong-Tai Chang

    (Department of Surgery, Kaohsiung Municipal United Hospital, Kaohsiung 80457, Taiwan
    Department of Business Management, National Sun Yat-sen University, Kaohsiung 80424, Taiwan)

  • Hong-Hsi Hsien

    (Department of Internal Medicine, St. Joseph Hospital, Kaohsiung 80288, Taiwan)

  • Kuo-Wei Hung

    (Division of Neurology, Department of Internal Medicine, Yuan’s General Hospital, Kaohsiung 80249, Taiwan)

  • Sheng-Li Tung

    (Department of Medical Research, Chiayi Chang Gung Hospital, Chiayi 61301, Taiwan)

  • Hon-Yi Shi

    (Department of Business Management, National Sun Yat-sen University, Kaohsiung 80424, Taiwan
    Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
    Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 08708, Taiwan
    Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan)

Abstract

In this large-scale prospective cohort study, a propensity score matching method was applied in a natural experimental design to investigate how post-acute care (PAC) after stroke affects functional status and to identify predictors of functional status. The main objective of this study was to examine longitudinal changes in various measures of functional status in stroke patients and predictors of scores for these measures before and after PAC. A group of patients who had received PAC for stroke at one of two medical centers (PAC group, n = 273) was compared with a group who had received standard care for stroke at one of four hospitals (three regional hospital and one district hospital; non-PAC group, n = 273) in Taiwan from March, 2014, to October, 2018. The patients completed the functional status measures before rehabilitation, the 12th week and the 1st year after rehabilitation. Generalized estimating equations were used to estimate differences-in-differences models for examining the effects of PAC. The average age was 68.0 (SD = 8.1) years, and males accounted for 57.9%. During the follow-up period, significant risk factors for poor functional outcomes were advanced age, hemorrhagic stroke, and poor function scores before rehabilitation ( p < 0.05). Between-group comparisons at subsequent time points revealed significantly higher functional status scores in the PAC group versus the non-PAC group ( p < 0.001). Notably, for all functional status measures, between-group differences in total scores significantly increased over time from baseline to 1 year post-rehabilitation ( p < 0.001). The contribution of this study is its further elucidation of the clinical implications and health policy implications of rehabilitative care after stroke. Specifically, it improves understanding of the effects of PAC in stroke patients at different follow-up times. Therefore, a policy implication of this study is that standard care for stroke should include intensive rehabilitative PAC to maximize recovery of overall function.

Suggested Citation

  • Chong-Chi Chiu & Hsiu-Fen Lin & Ching-Huang Lin & Hong-Tai Chang & Hong-Hsi Hsien & Kuo-Wei Hung & Sheng-Li Tung & Hon-Yi Shi, 2021. "Multidisciplinary Care after Acute Care for Stroke: A Prospective Comparison between a Multidisciplinary Post-Acute Care Group and a Standard Group Matched by Propensity Score," IJERPH, MDPI, vol. 18(14), pages 1-11, July.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:14:p:7696-:d:597631
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/18/14/7696/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/18/14/7696/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Sheyda Ghanbari Ghoshchi & Sara De Angelis & Giovanni Morone & Monica Panigazzi & Benedetta Persechino & Marco Tramontano & Edda Capodaglio & Pierluigi Zoccolotti & Stefano Paolucci & Marco Iosa, 2020. "Return to Work and Quality of Life after Stroke in Italy: A Study on the Efficacy of Technologically Assisted Neurorehabilitation," IJERPH, MDPI, vol. 17(14), pages 1-12, July.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Alba Aza & Miguel Á. Verdugo & María Begoña Orgaz & Antonio M. Amor & María Fernández, 2021. "Predictive Factors of Self-Reported Quality of Life in Acquired Brain Injury: One-Year Follow-Up," IJERPH, MDPI, vol. 18(3), pages 1-19, January.
    2. Roxana Steliana Miclaus & Nadinne Roman & Ramona Henter & Silviu Caloian, 2021. "Lower Extremity Rehabilitation in Patients with Post-Stroke Sequelae through Virtual Reality Associated with Mirror Therapy," IJERPH, MDPI, vol. 18(5), pages 1-14, March.
    3. José-María Figueredo & Cristina García-Ael & Andrea Gragnano & Gabriela Topa, 2020. "Well-Being at Work after Return to Work (RTW): A Systematic Review," IJERPH, MDPI, vol. 17(20), pages 1-27, October.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:18:y:2021:i:14:p:7696-:d:597631. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.