Oral Presentation Smart Strokes Annual Scientific Meeting 2025

Factors Influencing Access to Community Rehabilitation Following Inpatient Rehabilitation (127661)

Melita Stirling 1 , Catherine Burns 2 , Anne Egan 1 , Dean Crowthers 1 , Lisa Yates 1 , Lauren J Christie 3 4 5 , Tamina Levy 6 7 , Tara Purvis 2 , Dominique Cadilhac 2 8 , Kelvin Hill 1 , Monique Kilkenny 2 8
  1. Stroke Foundation, Melbourne, VIC, Australia
  2. Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia
  3. Allied Health Research Unit, St Vincent's Health Network Sydney, Darlinghurst, NSW, Australia
  4. Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne and Australian Catholic University, Darlinghurst, NSW, Australia
  5. School of Allied Health, Faculty of Health Sciences, Australian Catholic University, North Sydney, NSW, Australia
  6. College of Nursing and Health Sciences, Flinders University, Bedford Rock, South Austrlia, Australia
  7. Division Rehabilitation, Aged Care and Palliative Care, Southern Adelaide Local Health Network, Bedford Park, South Australia, Australia
  8. Stroke Theme, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia

 

 

Background: Access to community rehabilitation is critical to maximising recovery after stroke.  Little is known about factors that influence referral from inpatient rehabilitation services to community rehabilitation.  

 

Aim: We aimed to investigate factors associated with referral from inpatient to community rehabilitation services using data from the National Rehabilitation Stroke Services Audit 2024.

 

Methods: Organisational surveys and retrospective clinical data were analysed. Descriptive statistics and multivariable logistic regression with site clustering were used to assess factors associated with referral to community-based rehabilitation (day-hospital or home based). Models were adjusted for age, sex, stroke type, independence on admission to inpatient rehabilitation (modified Rankin Scale 0-2), stroke severity, hospital size and location.

 

Results: Among 3404 patients who were discharged from inpatient rehabilitation services, 908 (27%) were referred to community rehabilitation. The referred patients were more likely to be male (referred 61% vs not 56%), independent on admission (12% vs 9%) and in a large stroke rehabilitation service (>80 annual stroke admissions; referred 54% vs not 38%) in a major city (80% vs 55%). Having a neuropsychologist on staff (OR 1.89 95% CI 1.03, 3.46) and processes to follow up patient needs after discharge (OR 2.70 95% CI 1.38, 5.29) were associated with referral to community rehabilitation.  

 

Conclusion: There were organisational and patient-level factors that were associated with access to community rehabilitation upon discharge from inpatient rehabilitation, for patients with stroke.

 

Relevance to clinical practice or patient experience:

These findings suggest a need for resourcing and processes that enable equitable access to community rehabilitation for stroke, regardless of sex, admission status, hospital location or size.