Stroke Case Study Occupational Therapy

This study will test this assumption in patients admitted who are less than 10 days after stroke and compare the OT and PT service delivery in one metropolitan hospital to the OT and PT in four rural hospitals.This retrospective case-control study analysed OT and PT service delivery data in acute stroke across five participating hospitals.

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Healthcare that targets functional outcomes and promotes independence is central to poststroke occupational therapy (OT) and physiotherapy (PT) [9, 10].

OT focusses on sensorimotor function (particularly related to upper limb), participation in everyday activities, processing skills, and the adaptation of an occupation or environment [11, 12].

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. To assess whether acute stroke patients in rural hospitals receive less occupational therapy and physiotherapy than those in metropolitan hospitals. Retrospective case-control study of health data in patients ≤10 days after stroke. Occupational therapy and physiotherapy services in four rural hospitals and one metropolitan hospital. Acute stroke patients admitted in one health district. Frequency and duration of face-to-face and indirect therapy sessions. Rural hospitals admitted 363 patients and metropolitan hospital admitted 378 patients. Those in rural hospitals received more face-to-face (). The dose of therapy was lower than recommended, and the referral process may unnecessarily delay the time from admission to a patient’s first therapy session.

Acute stroke patients in Australian rural hospital may receive more occupational therapy and less physiotherapy than those in metropolitan hospitals.

Because some hospitals require that a medical referral be forwarded to therapists, this study also investigated whether or not the patient was seen within 24 hours of being referred. Descriptive statistics described the frequency of sessions, duration of session, and the type of session (direct or indirect).

A t-test with values set at 0.001 was used to test for differences between what occurred in the metropolitan hospital and what occurred in the rural hospitals.The primary outcome was service delivery for OT and PT as measured in frequency and duration of sessions against type of session.The type of session was defined as direct or indirect.For the purposes of this study, all four hospitals will be referred to as rural.This study received ethical approval from the region’s NSW Health Human Research Ethics Committee and this provided access to data from the health services’ hospital and allied health databases.Patients excluded from the analysis were those with a secondary diagnosis of stroke on admission, those admitted for subacute care only, and/or those awaiting placement in supported accommodation (Figure 1).Patients were also excluded if they were admitted in late 2011 and were still in hospital during 2012, if they had no allied health data, and/or if they died during the 10-day period before receiving therapy.The metropolitan hospital is the referral hospital for the four rural hospitals.The rural hospitals include two that are classified as “regional” and two that are classified as “rural” as defined by the Australian Standard Geographical Classification: Remoteness [20].Direct sessions included face-to-face contact with the patient and their family and/or carers and phone calls and/or meetings where the patient and/or family and carers were present.Indirect therapy included report-writing, attending case conferences, and any discharge or session planning that did not involve direct contact with the patient and/or their family.

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