The impact of social determinents of health on stroke rehabilitation service utilization measured during acute stroke hospitalization.

IF 2.2 4区医学 Q1 REHABILITATION

Topics in Stroke Rehabilitation Pub Date : 2025-02-19 DOI:10.1080/10749357.2025.2466391

Heather Shaw Bonilha, Tianwen Ma, Shyam Prabhakaran, Lori J Bhadsavle, Samir R Belagaje, Debra Blanke, Laura Henriquez, Danielle Starnes, Hannah Christopher, Jacqueline Cabral, Teri Walczak, Fadi Nahab

{"title":"The impact of social determinents of health on stroke rehabilitation service utilization measured during acute stroke hospitalization.","authors":"Heather Shaw Bonilha, Tianwen Ma, Shyam Prabhakaran, Lori J Bhadsavle, Samir R Belagaje, Debra Blanke, Laura Henriquez, Danielle Starnes, Hannah Christopher, Jacqueline Cabral, Teri Walczak, Fadi Nahab","doi":"10.1080/10749357.2025.2466391","DOIUrl":null,"url":null,"abstract":"Background: Rehabilitation is the primary method of promoting functional recovery post-stroke. Identification of patients for rehabilitation services during the acute stroke hospitalization is essential to delivery of rehabilitation services. Social determinants of health (SDOH) impact health care and health outcomes in a myriad of ways, but it is unknown whether SDOH affects rehabilitation services utilization.Objectives: This study elucidates the relationship of, and additional explanatory value of, county-level metrics of SDOH on rehabilitation services utilization during acute inpatient hospitalization for stroke.Methods: Using the American Heart Association Get with the Guidelines®-Stroke registry and the Institute for Health Metrics and Evaluation data, we investigated the impact of SDOH on rehabilitation services utilization over the years ranging from 2010 to 2019 in hospitalized ischemic stroke or intracerebral hemorrhage stroke patients. Analyses focused on determining which county-level SDOH metrics influenced rehabilitation services utilization using generalized linear mixed models. Akaike Information Criterion was used for model selection.Results: County-level SDOH improved the predictive ability of the models to determine who would be transferred to a rehabilitation facility and who would be referred for rehabilitation after discharge. We found indicators that county-level metrics of high school education (p = 0.0003), being foreign-born (p < 0.001), and rurality of the hospital (p = 0.004) influenced rehabilitation services utilization.Conclusions: SDOH impact rehabilitation utilization after acute stroke hospitalization. Future studies should focus on both individual- and county-level metrics of SDOH and their impact on access to rehabilitation. This information should be used to develop interventions to improve the equity of rehabilitation utilization after stroke.","PeriodicalId":23164,"journal":{"name":"Topics in Stroke Rehabilitation","volume":" ","pages":"1-8"},"PeriodicalIF":2.2000,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Topics in Stroke Rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/10749357.2025.2466391","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Rehabilitation is the primary method of promoting functional recovery post-stroke. Identification of patients for rehabilitation services during the acute stroke hospitalization is essential to delivery of rehabilitation services. Social determinants of health (SDOH) impact health care and health outcomes in a myriad of ways, but it is unknown whether SDOH affects rehabilitation services utilization.

Objectives: This study elucidates the relationship of, and additional explanatory value of, county-level metrics of SDOH on rehabilitation services utilization during acute inpatient hospitalization for stroke.

Methods: Using the American Heart Association Get with the Guidelines®-Stroke registry and the Institute for Health Metrics and Evaluation data, we investigated the impact of SDOH on rehabilitation services utilization over the years ranging from 2010 to 2019 in hospitalized ischemic stroke or intracerebral hemorrhage stroke patients. Analyses focused on determining which county-level SDOH metrics influenced rehabilitation services utilization using generalized linear mixed models. Akaike Information Criterion was used for model selection.

Results: County-level SDOH improved the predictive ability of the models to determine who would be transferred to a rehabilitation facility and who would be referred for rehabilitation after discharge. We found indicators that county-level metrics of high school education (p = 0.0003), being foreign-born (p < 0.001), and rurality of the hospital (p = 0.004) influenced rehabilitation services utilization.

Conclusions: SDOH impact rehabilitation utilization after acute stroke hospitalization. Future studies should focus on both individual- and county-level metrics of SDOH and their impact on access to rehabilitation. This information should be used to develop interventions to improve the equity of rehabilitation utilization after stroke.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Topics in Stroke Rehabilitation 医学-康复医学

CiteScore

5.10

自引率

4.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Topics in Stroke Rehabilitation is the leading journal devoted to the study and dissemination of interdisciplinary, evidence-based, clinical information related to stroke rehabilitation. The journal’s scope covers physical medicine and rehabilitation, neurology, neurorehabilitation, neural engineering and therapeutics, neuropsychology and cognition, optimization of the rehabilitation system, robotics and biomechanics, pain management, nursing, physical therapy, cardiopulmonary fitness, mobility, occupational therapy, speech pathology and communication. There is a particular focus on stroke recovery, improving rehabilitation outcomes, quality of life, activities of daily living, motor control, family and care givers, and community issues. The journal reviews and reports clinical practices, clinical trials, state-of-the-art concepts, and new developments in stroke research and patient care. Both primary research papers, reviews of existing literature, and invited editorials, are included. Sharply-focused, single-issue topics, and the latest in clinical research, provide in-depth knowledge.